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Wang Z, Zhang K, Zhong C, Zhu Z, Zheng X, Yang P, Che B, Lu Y, Zhang Y, Xu T. Plasma human cartilage glycoprotein-39 and depressive symptoms among acute ischemic stroke patients. Gen Hosp Psychiatry 2025; 94:120-125. [PMID: 40068363 DOI: 10.1016/j.genhosppsych.2025.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Revised: 03/05/2025] [Accepted: 03/05/2025] [Indexed: 04/12/2025]
Abstract
OBJECTIVE Our study aimed at evaluating the association between plasma human cartilage glycoprotein-39 (YKL-40) and depressive symptoms at 3 months among acute ischemic stroke patients. METHODS Plasma YKL-40 levels were measured in 619 patients with ischemic stroke who participated in the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). The patients' depressive symptoms at 3 months after stroke were assessed using the Hamilton Rating Scale for Depression (HRSD-24). RESULTS During the 3-month follow-up period, 242 (39.1 %) participants were classified as experiencing depressive symptoms. Patients in the highest quartile of YKL-40 had a 1.98-fold (95 %CI: 1.19-3.30, P for trend = 0.02) risk of depressive symptoms compared with those in the lowest quartile. Per 1-SD increase of logarithm-transformed YKL-40 was associated with a 32 % (95 % CI: 10 %-58 %) increased risk for the depressive symptoms. The multiple-adjusted spline regression model confirmed dose-response relationships between YKL-40 levels and depressive symptoms (P for linearity = 0.02). Adding YKL-40 to a model containing conventional risk factors significantly improved the discriminatory power (area under the receiver operating characteristic curve improved by 0.02, P = 0.04) and reclassification power for depressive symptoms (net reclassification improvement = 18.77 %, P = 0.02; integrated discrimination improvement = 1.30 %, P = 0.005). CONCLUSIONS Elevated YKL-40 levels might be a potential risk marker of depressive symptoms at 3 months among acute ischemic stroke patients. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT01840072.
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Affiliation(s)
- Ziyi Wang
- Department of Neurology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
| | - Kaixin Zhang
- Department of Clinical Research Center, Wuxi No.2 People's Hospital (Jiangnan University Medical Center), Wuxi, Jiangsu 214002, China; Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Zhengbao Zhu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Xiaowei Zheng
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Pinni Yang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Bizhong Che
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Yaling Lu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Tian Xu
- Department of Neurology, Affiliated Hospital of Nantong University, Nantong 226001, China..
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He Y, Chang X, Liu Y, Fei J, Qin X, Song B, Yu Q, Yang P, Shi M, Guo D, Peng Y, Chen J, Wang A, Xu T, He J, Zhang Y, Zhu Z. Plasma polyamines levels and post-stroke depression in ischemic stroke patients: A multicenter prospective study. Atherosclerosis 2025; 403:119150. [PMID: 40043446 DOI: 10.1016/j.atherosclerosis.2025.119150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 02/17/2025] [Accepted: 02/19/2025] [Indexed: 04/20/2025]
Abstract
BACKGROUND AND AIMS Polyamines have been suggested to implicated in inflammation, ischemic stroke, and mental disorders, but the associations of polyamines with post-stroke depression (PSD) remain unclear. We aimed to prospectively investigate the associations of plasma putrescine, spermidine and spermine with PSD among ischemic stroke patients in a multicenter cohort study. METHODS We measured plasma putrescine, spermidine and spermine levels at baseline among 635 ischemic stroke patients from a preplanned ancillary study of the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). The study outcome was depression (Hamilton Depression Rating Scale score ≥8) at 3-month follow-up after ischemic stroke. RESULTS Plasma putrescine and spermidine were positively associated with the risk of PSD. The adjusted odds ratios of PSD for the highest versus lowest tertile of putrescine and spermidine were 1.77 (95 % CI, 1.13-2.78; ptrend = 0.014) and 1.77 (95 % CI, 1.11-2.82; ptrend = 0.013), respectively. Multivariable-adjusted spline regression analyses showed linear associations of plasma putrescine (p = 0.002 for linearity) and spermidine (p = 0.008 for linearity) with PSD. In addition, plasma putrescine (continuous net reclassification improvement [NRI]: 26.33 %, p = 0.002; integrated discrimination improvement [IDI]: 1.06 %, p = 0.009) and spermidine (continuous NRI: 20.72 %, p = 0.013; IDI: 1.04 %, p = 0.010) could significantly improve the risk reclassification of PSD beyond the established risk factors. CONCLUSIONS High plasma putrescine and spermidine levels were associated with increased risk of PSD among ischemic stroke patients. Our findings suggest that plasma polyamines should be implicated in the pathophysiologic processes of PSD and may be the potential intervention targets for PSD.
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Affiliation(s)
- Yu He
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Xinyue Chang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Yi Liu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Jiawen Fei
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Xiaoli Qin
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Beiping Song
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Quan Yu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Pinni Yang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Mengyao Shi
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Ave, SL 18, New Orleans, LA, 70112, USA
| | - Daoxia Guo
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Yanbo Peng
- Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan, 063000, Hebei Province, China
| | - Jing Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Ave, SL 18, New Orleans, LA, 70112, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, 70112, USA
| | - Aili Wang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Ave, SL 18, New Orleans, LA, 70112, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, 70112, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Zhengbao Zhu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province, 215123, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Ave, SL 18, New Orleans, LA, 70112, USA.
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Reber S, Herr AS, Unterecker S, Scherf-Clavel M. Serum Concentration of Antidepressant Drugs in Geriatric Day Care Patients With Renal Insufficiency and Multimorbidity. Ther Drug Monit 2025; 47:297-302. [PMID: 39588925 DOI: 10.1097/ftd.0000000000001285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2024] [Indexed: 11/27/2024]
Abstract
BACKGROUND Geriatric depression is challenging to treat owing to age-related changes in pharmacokinetics and comorbidities. Although renal insufficiency and multimorbidity are typical geriatric complications that cannot be completely separated from each other, no study has examined the influence of these factors on the serum concentrations of antidepressants. For the first time, we evaluated the effects of these factors in combination on the dose-corrected serum concentration (C/D) of antidepressants in geriatric patients. METHODS In this retrospective study, data from 123 geriatric patients in a gerontopsychiatric day care unit at the University Hospital of Würzburg were analyzed. Multiple linear regression analysis and analysis of variance with confounders were used to examine the associations between glomerular filtration rate (GFR) and stages of renal impairment and the C/D of venlafaxine, mirtazapine, sertraline, and escitalopram corrected for multimorbidity, sex, lithium intake, and the number of triple whammy drugs. RESULTS GFR ( P < 0.001, ß = -0.070) was associated with the C/D of the active moiety of venlafaxine (N = 32). GFR, multimorbidity, and sex were not associated with the C/D of mirtazapine, escitalopram, or sertraline. CONCLUSIONS As the influence of sex may be less pronounced than that of decreasing GFR in terms of the C/D of the active moiety of venlafaxine in geriatric patients, we recommend considering the GFR for dose adjustment rather than sex. In conclusion, even in patients with mild renal impairment, serum venlafaxine concentration should be monitored to prevent overdosing. Mirtazapine, sertraline, and escitalopram may be well-suited antidepressants for geriatric patients with renal function impairment stage 2-3 as well as multimorbidity.
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Affiliation(s)
- Sibylle Reber
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
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Bauer JF, Schindler-Gmelch L, Gerczuk M, Schuller B, Berking M. Prosody-focused feedback enhances the efficacy of anti-depressive self-statements in depressed individuals - A randomized controlled trial. Behav Res Ther 2025; 184:104667. [PMID: 39700643 DOI: 10.1016/j.brat.2024.104667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 08/05/2024] [Accepted: 12/06/2024] [Indexed: 12/21/2024]
Abstract
This study was aimed to evaluate whether the efficacy of invoking anti-depressive self-statements to cope with depressed mood can be enhanced for depressed individuals by systematically guiding them to amplify the expression of conviction in their voice. Accordingly, we recruited N = 144 participants (48 clinically depressed individuals, 48 sub-clinically depressed individuals, and 48 non-depressed individuals). Participants were randomly assigned to an experimental or control condition. Across study conditions, participants completed a mood induction procedure, then read aloud scripted anti-depressive self-statements designed to reduce depressed mood. Participants in the experimental condition received instructions to heighten the prosodic expression of conviction in their voice; participants in the control condition received no prosodic expression instructions. Results showed that depressed participants achieved a more pronounced decrease of depressed mood in the experimental condition than in the control condition. Further, the results indicated no effects in sub-clinically depressed and non-depressed individuals. Finally, heightened conviction expressed by participants in the experimental condition was associated with lower depressed mood and diminished depressive symptom severity. Overall, our findings suggest that fostering the prosodic expression of conviction in depressed persons' voices, while they vocalize anti-depressive self-statements, represents a promising method for augmenting the efficacy of cognitive interventions for depression.
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Affiliation(s)
- Jonathan F Bauer
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen Nürnberg, Nägelsbachstraße 25a, 91052, Erlangen, Germany.
| | - Lena Schindler-Gmelch
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen Nürnberg, Nägelsbachstraße 25a, 91052, Erlangen, Germany.
| | - Maurice Gerczuk
- Chair of Health Informatics, MRI, Technical University Munich, Ismaninger Straße 22, 81675 München, Germany; Munich Center for Machine Learning, Arcisstraße 21, 80333 München, Germany.
| | - Björn Schuller
- Chair of Health Informatics, MRI, Technical University Munich, Ismaninger Straße 22, 81675 München, Germany; Munich Center for Machine Learning, Arcisstraße 21, 80333 München, Germany; GLAM - Group on Language, Audio, & Music, Imperial College London, London, SW7 2AZ, UK.
| | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen Nürnberg, Nägelsbachstraße 25a, 91052, Erlangen, Germany.
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Chang X, He Y, Liu Y, Fei J, Qin X, Song B, Yu Q, Shi M, Guo D, Hui L, Chen J, Wang A, Xu T, He J, Zhang Y, Zhu Z. Serum brain derived neurotrophic factor levels and post-stroke depression in ischemic stroke patients. J Affect Disord 2024; 361:341-347. [PMID: 38897298 DOI: 10.1016/j.jad.2024.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 06/04/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) is crucial for neuronal survival and may be implicated in the pathophysiological process of depression. This study aimed to prospectively investigate the association between serum BDNF and post-stroke depression (PSD) at 3 months in a multicenter cohort study. METHODS A total of 611 ischemic stroke patients with serum BDNF measurements from the China Antihypertensive Trial in Acute Ischemic Stroke were included in this analysis. We used the 24-item Hamilton Depression Rating Scale to assess depression status at 3 months after ischemic stroke, and PSD was defined as a score of ≥8. RESULTS Baseline serum BDNF was inversely associated with the risk of depression after ischemic stroke. The multivariable-adjusted odds ratio of PSD for the highest tertile of BDNF was 0.53 (95 % confidence interval, 0.34-0.82; P for trend = 0.004) compared with the lowest tertile. Multivariable-adjusted spline regression model also showed a linear does-response association between serum BDNF levels and PSD at 3 months (P for linearity = 0.006). In addition, adding serum BDNF to conventional risk factors significantly improved the risk reclassification of PSD (net reclassification improvement: 16.98 %, P = 0.039; integrated discrimination index: 0.93 %, P = 0.026). LIMITATIONS All patients in this study were Chinese, so our findings should be applied to other populations cautiously. CONCLUSIONS Higher serum BDNF levels at baseline were significantly associated with a decreased risk of PSD at 3 months, suggesting that BDNF might be a valuable predictive biomarker and potential therapeutic target for PSD among ischemic stroke patients.
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Affiliation(s)
- Xinyue Chang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yu He
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yi Liu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Jiawen Fei
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Xiaoli Qin
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Beiping Song
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Quan Yu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Mengyao Shi
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
| | - Daoxia Guo
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Li Hui
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Jing Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Aili Wang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Zhengbao Zhu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America.
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Xie XM, Sha S, Cai H, Liu X, Jiang I, Zhang L, Wang G. Resting-State Alpha Activity in the Frontal and Occipital Lobes and Assessment of Cognitive Impairment in Depression Patients. Psychol Res Behav Manag 2024; 17:2995-3003. [PMID: 39176258 PMCID: PMC11339342 DOI: 10.2147/prbm.s459954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 08/12/2024] [Indexed: 08/24/2024] Open
Abstract
Background Major depressive disorder (MDD) becomes one of the psychiatric disorders characteristic of a combination of cognitive, emotional, and somatic symptoms. Additionally, cognitive impairment has the most significant impact on functional results. However, the evaluation of cognitive level is still based on various subjective questionnaires as there is no objective standard assessment yet. This research focuses on resting-state alpha activity to identify cognition in MDD patients using electroencephalography (EEG) signals. Methods Ninety-two subjects were recruited: 44 patients with MDD and 48 healthy individuals as controls. Functional outcome and cognition were assessed using standardized instruments, and the EEG resting state signal of open and closed eyes was recorded. The comparison and correlation of cognitive levels with alpha power in the bilateral frontal region, bilateral central region, bilateral occipital region, and middle line was evaluated. Results The relative alpha power in MDD group was significantly lower than that in the control group (P < 0.05). Through correlation analysis, it was shown that the bilateral frontal and occipital alpha power of MDD patients in the closed-eyes state was positively correlated with information processing rate, verbal learning, working memory, and attention retention. The alpha power of the bilateral frontal region in the open-eyes state was positively correlated with information processing rate, working memory, and attention retention (P < 0.05). Conclusion The research indicates that the changes in frontal and occipital alpha activities may be a promising neurophysiological indicator of cognitive level to diagnose and treat response prediction.
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Affiliation(s)
- Xiao-Meng Xie
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, People’s Republic of China
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, People’s Republic of China
| | - Hong Cai
- Unit of Medical Psychology and Behavior Medicine, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Xinyu Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, People’s Republic of China
| | - Isadora Jiang
- Bellarmine College of Liberal Arts, Loyola Marymount University, Los Angeles, CA, USA
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, People’s Republic of China
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, People’s Republic of China
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Zhang X, Cheng X, Chen J, Sun J, Yang X, Li W, Chen L, Mao Y, Liu Y, Zeng X, Ye B, Yang C, Li X, Cao L. Distinct global brain connectivity alterations in depressed adolescents with subthreshold mania and the relationship with processing speed: Evidence from sBEAD Cohort. J Affect Disord 2024; 357:97-106. [PMID: 38657768 DOI: 10.1016/j.jad.2024.04.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/06/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Bipolar disorder (BD) is a progressive condition. Investigating the neuroimaging mechanisms in depressed adolescents with subthreshold mania (SubMD) facilitates the early identification of BD. However, the global brain connectivity (GBC) patterns in SubMD patients, as well as the relationship with processing speed before the onset of full-blown BD, remain unclear. METHODS The study involved 72 SubMD, 77 depressed adolescents without subthreshold mania (nSubMD), and 69 gender- and age-matched healthy adolescents (HCs). All patients underwent a clinical follow-up ranging from six to twelve months. We calculated the voxel-based graph theory analysis of the GBC map and conducted the TMT-A test to measure the processing speed. RESULTS Compared to HCs and nSubMD, SubMD patients displayed distinctive GBC index patterns: GBC index decreased in the right Medial Superior Frontal Gyrus (SFGmed.R)/Superior Frontal Gyrus (SFG) while increased in the right Precuneus and left Postcentral Gyrus. Both patient groups showed increased GBC index in the right Inferior Temporal Gyrus. An increased GBC value in the right Supplementary Motor Area was exclusively observed in the nSubMD-group. There were opposite changes in the GBC index in SFGmed.R/SFG between two patient groups, with an AUC of 0.727. Additionally, GBC values in SFGmed.R/SFG exhibited a positive correlation with TMT-A scores in SubMD-group. LIMITATIONS Relatively shorter follow-up duration, medications confounding, and modest sample size. CONCLUSION These findings suggest that adolescents with subthreshold BD have specific impairments patterns at the whole brain connectivity level associated with processing speed impairments, providing insights into early identification and intervention strategies for BD.
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Affiliation(s)
- Xiaofei Zhang
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong province 510000, PR China
| | - Xiaofang Cheng
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Jianshan Chen
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Jiaqi Sun
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Xiaoyong Yang
- Department of Psychiatry, Guangzhou Medical University, Guangdong province 510300, PR China
| | - Weiming Li
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Lei Chen
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Yimiao Mao
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Yutong Liu
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Xuanlin Zeng
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Biyu Ye
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Chanjuan Yang
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Xuan Li
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China.
| | - Liping Cao
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China.
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Gao N, Wu L, Liu X, Lin Z, Liu Z, Liang J, Wang W. Effects of electroacupuncture on treatment-resistant chronic migraine with medication overuse headache: A 12-month follow-up case report. Heliyon 2024; 10:e30417. [PMID: 38720738 PMCID: PMC11076970 DOI: 10.1016/j.heliyon.2024.e30417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
Background Medication overuse headache (MOH) is a secondary headache disorder that leads to pronounced disability and decreased quality of life. Available therapeutic options for MOH are limited, and many are only effective in a subset of individuals. Although the existing evidence is limited, acupuncture may be an effective treatment option for MOH. Case presentation A 45-year-old Chinese woman presented to the Medical Acupuncture Department of Sanming Integrated Traditional Chinese and Western Medicine Hospital on April 11, 2022. Thirty-five years ago, she had episodic migraines. The frequency increased over time, however, and for the past 10 years she has had daily headaches. These headaches were characterized by daily persistent throbbing pain on the left side of the patient's head, accompanied by photophobia, phonophobia, neck stiffness, dizziness, and fatigue. Without painkillers, the patient rated her headache intensity as 9 out of 10 on a visual analog scale (0 = no pain, 10 = intolerable pain), and reported that the headaches lasted for up to 7 days or more. With painkillers, the headaches had a reduced intensity (5 of 10), but persisted. The patient had taken 1-3.5 compound aminopyrine phenacetin tablets daily for more than 5 years. Standard conservative therapy (patient education, medication withdrawal, and behavioral intervention) for MOH had failed to improve her symptoms. Before her visit, the patient had headache and engaged in short-term medication use on 30 days per month. The total monthly headache intensity score was 90. The patient's Migraine-Specific Quality of Life Questionnaire (MSQ) score was 33 points, her Hamilton Depression Scale (HAMD) score was 24 points, and her Hamilton Anxiety Scale (HAMA) score was 20 points. Results After 48 acupuncture sessions over 24 weeks, the patient completely discontinued short-term analgesic use and the monthly number of headache days and headache intensity score were both reduced by 96.67 % (from 30 to 1 and 90 to 3, respectively), with no adverse effect. Compared with baseline, the MSQ, HAMD, and HAMA scores improved by 45, 17, and 16 points, respectively. At 12 months, the patient's condition remained stable and her MOH had not relapsed. Conclusion In the context of the current literature and the present case, electroacupuncture shows promise for the long-term relief of chronic migraine with MOH when other treatments fail.
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Affiliation(s)
- Ning Gao
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Lili Wu
- Department of Rehabilitation, Shaxian District Hospital of Traditional Chinese Medicine, Sanming, 365500, China
| | - Xinkun Liu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Zhenyu Lin
- Department of Rehabilitation, Sanming Integrated Traditional Chinese and Western Medicine Hospital, Sanming, 365500, China
| | - Zhishun Liu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Jun Liang
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Weiming Wang
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
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9
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Bauer JF, Gerczuk M, Schindler-Gmelch L, Amiriparian S, Ebert DD, Krajewski J, Schuller B, Berking M. Validation of Machine Learning-Based Assessment of Major Depressive Disorder from Paralinguistic Speech Characteristics in Routine Care. Depress Anxiety 2024; 2024:9667377. [PMID: 40226679 PMCID: PMC11919192 DOI: 10.1155/2024/9667377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 03/14/2024] [Accepted: 03/22/2024] [Indexed: 04/15/2025] Open
Abstract
New developments in machine learning-based analysis of speech can be hypothesized to facilitate the long-term monitoring of major depressive disorder (MDD) during and after treatment. To test this hypothesis, we collected 550 speech samples from telephone-based clinical interviews with 267 individuals in routine care. With this data, we trained and evaluated a machine learning system to identify the absence/presence of a MDD diagnosis (as assessed with the Structured Clinical Interview for DSM-IV) from paralinguistic speech characteristics. Our system classified diagnostic status of MDD with an accuracy of 66% (sensitivity: 70%, specificity: 62%). Permutation tests indicated that the machine learning system classified MDD significantly better than chance. However, deriving diagnoses from cut-off scores of common depression scales was superior to the machine learning system with an accuracy of 73% for the Hamilton Rating Scale for Depression (HRSD), 74% for the Quick Inventory of Depressive Symptomatology-Clinician version (QIDS-C), and 73% for the depression module of the Patient Health Questionnaire (PHQ-9). Moreover, training a machine learning system that incorporated both speech analysis and depression scales resulted in accuracies between 73 and 76%. Thus, while findings of the present study demonstrate that automated speech analysis shows the potential of identifying patterns of depressed speech, it does not substantially improve the validity of classifications from common depression scales. In conclusion, speech analysis may not yet be able to replace common depression scales in clinical practice, since it cannot yet provide the necessary accuracy in depression detection. This trial is registered with DRKS00023670.
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Affiliation(s)
- Jonathan F. Bauer
- Department for Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Maurice Gerczuk
- Chair of Embedded Intelligence for Health Care & Wellbeing, University of Augsburg, 86159 Augsburg, Germany
| | - Lena Schindler-Gmelch
- Department for Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Shahin Amiriparian
- Chair of Embedded Intelligence for Health Care & Wellbeing, University of Augsburg, 86159 Augsburg, Germany
| | - David Daniel Ebert
- Department for Sport and Health Sciences, Technical University Munich, 80992 Munich, Germany
| | - Jarek Krajewski
- Rhenish University of Applied Science Cologne, 50676 Cologne, Germany
| | - Björn Schuller
- Chair of Embedded Intelligence for Health Care & Wellbeing, University of Augsburg, 86159 Augsburg, Germany
- Group on Language, Audio, & Music, Imperial College London, London SW7 2AZ, UK
| | - Matthias Berking
- Department for Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
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10
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Belli GM, Law C, Obisie-Orlu IC, Eisen JL, Rasmussen SA, Boisseau CL. Course and clinical correlates of obsessive-compulsive disorder with or without comorbid personality disorder. J Affect Disord 2024; 348:218-223. [PMID: 38145841 PMCID: PMC10939496 DOI: 10.1016/j.jad.2023.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/13/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Personality disorders (PDs) are often comorbid with obsessive-compulsive disorder (OCD) which may influence symptom presentation and course. This investigation sought to examine the impact of comorbid PDs on clinical presentation and symptom chronicity in a large, prospective longitudinal OCD study. METHODS Participants (n = 263) were treatment-seeking adults with a primary diagnosis of OCD separated into two groups: individuals with and without a co-occurring PD. We conducted two-tailed t-tests to compare symptom severity, functioning, and quality of life between the OCD + PD group (n = 117) and the OCD w/o PD group (n = 146). Chronicity analyses were conducted to compare the amount of time in-episode for OCD and major depressive disorder (MDD) between the two groups. RESULTS The OCD + PD group reported greater OCD and depression severity, lower levels of psychosocial functioning and worse quality of life than the OCD w/o PD group. The OCD + PD group exhibited greater OCD and MDD symptom chronicity; over 5 years the OCD + PD group spent 16.2 % weeks longer at full criteria for OCD and three times as many weeks in episode for MDD than the OCD w/o PD group. LIMITATIONS Focusing on PDs as a group limited our ability to make observations about specific PDs. Further, the participants in our sample were predominantly White and all were treatment seeking which limits the generalizability of our findings. CONCLUSIONS Our results suggest that those with OCD and comorbid PDs present with greater overall impairment and may require additional considerations during treatment conceptualization and planning.
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Affiliation(s)
- Gina M Belli
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Clara Law
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Immanuela C Obisie-Orlu
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jane L Eisen
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Steven A Rasmussen
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI, USA
| | - Christina L Boisseau
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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11
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Fan Y, Eisen JL, Rasmussen SA, Boisseau CL. The relationship between obsessive-compulsive disorder symptom subtypes and social adjustment. J Obsessive Compuls Relat Disord 2023; 38:100826. [PMID: 37547666 PMCID: PMC10399149 DOI: 10.1016/j.jocrd.2023.100826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Background Although it has been widely established that poor social functioning is a characteristic of obsessive-compulsive disorder (OCD), little research has examined the relationship between OCD symptom subtypes and domains of social functioning. Thus, the present study sought to examine the specific ways in which impairment in social adjustment occurs in each symptom subtype of OCD. Methods A total of 325 adult participants with a primary diagnosis of OCD were included in the study. Hierarchical linear regressions were used to compare the extent to which OCD symptom subtypes predicted social adjustment domains after controlling for OCD and depression severity. Results Hoarding was shown to be significantly associated with work functioning. Whereas both contamination and symmetry subtypes were significantly associated with social functioning, only the contamination subtype was associated with functioning within the family unit. The symptom subtypes of doubt and taboo thoughts were not significantly associated with any domains of social adjustment. Conclusion Consistent with previous research, our results suggest a differential impact of OCD symptom subtypes on social adjustment. They offer important implications for the specific domains to target in treatment for different symptom subtypes.
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Affiliation(s)
- Yiqing Fan
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Jane L. Eisen
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Steven A. Rasmussen
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Christina L. Boisseau
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
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12
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Curtiss JE, Bernstein EE, Wilhelm S, Phillips KA. Predictors of pharmacotherapy outcomes for body dysmorphic disorder: a machine learning approach. Psychol Med 2023; 53:3366-3376. [PMID: 35000652 PMCID: PMC9836197 DOI: 10.1017/s0033291721005390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Serotonin-reuptake inhibitors (SRIs) are first-line pharmacotherapy for the treatment of body dysmorphic disorder (BDD), a common and severe disorder. However, prior research has not focused on or identified definitive predictors of SRI treatment outcomes. Leveraging precision medicine techniques such as machine learning can facilitate the prediction of treatment outcomes. METHODS The study used 10-fold cross-validation support vector machine (SVM) learning models to predict three treatment outcomes (i.e. response, partial remission, and full remission) for 97 patients with BDD receiving up to 14-weeks of open-label treatment with the SRI escitalopram. SVM models used baseline clinical and demographic variables as predictors. Feature importance analyses complemented traditional SVM modeling to identify which variables most successfully predicted treatment response. RESULTS SVM models indicated acceptable classification performance for predicting treatment response with an area under the curve (AUC) of 0.77 (sensitivity = 0.77 and specificity = 0.63), partial remission with an AUC of 0.75 (sensitivity = 0.67 and specificity = 0.73), and full remission with an AUC of 0.79 (sensitivity = 0.70 and specificity = 0.79). Feature importance analyses supported constructs such as better quality of life and less severe depression, general psychopathology symptoms, and hopelessness as more predictive of better treatment outcome; demographic variables were least predictive. CONCLUSIONS The current study is the first to demonstrate that machine learning algorithms can successfully predict treatment outcomes for pharmacotherapy for BDD. Consistent with precision medicine initiatives in psychiatry, the current study provides a foundation for personalized pharmacotherapy strategies for patients with BDD.
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Affiliation(s)
- Joshua E. Curtiss
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Emily E. Bernstein
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sabine Wilhelm
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Katharine A. Phillips
- Rhode Island Hospital, Butler Hospital, and Alpert Medical School of Brown University, Providence, RI, USA
- New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, USA
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13
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Xu H, Wang Y, Wang YM, Cao Y, Li P, Hu Y, Xia G. Insomniacs show greater prefrontal activation during verbal fluency task compared to non-insomniacs: a functional near-infrared spectroscopy investigation of depression in patients. BMC Psychiatry 2023; 23:217. [PMID: 36997897 PMCID: PMC10064712 DOI: 10.1186/s12888-023-04694-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/17/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Previous studies have shown that insomnia affects human prefrontal function and that there are specific patterns of brain activation to counteract sleep and improve cognition. However, the effects of insomnia on the prefrontal cortex of MDD (major depressive disorder) patients and the patterns of activation to counteract sleep in MDD patients remain unclear. The aim of this study is to examine this using fNIRS (functional near-infrared spectroscopy). METHODS Eighty depressed patients and 44 healthy controls were recruited for this study. fNIRS was used to assess changes in the concentration of oxygenated hemoglobin ([oxy-Hb]) in the prefrontal cortex of all participants during the VFT (verbal fluency test) and to record the number of words created to assess cognitive ability. The Pittsburgh Sleep Quality Index was used to assess sleep quality, and the Hamilton Rating Scale for Depression (24-item) and Hamilton Rating Scale for Anxiety (14-item) were used to assess the severity of depression and anxiety. RESULTS When comparing patients, the healthy control group had significantly higher [oxy-Hb] values in the bilateral prefrontal cortex during VFT than the MDD group. In the MDD group, the [oxy-Hb] values in all brain regions except the right DLPFC were significantly higher in the group with insomnia than in the group without insomnia, but their VFT performance was significantly lower than in the group without insomnia and the healthy group. PSQI scores were positively correlated with [oxy-Hb] values in some left-brain regions, whereas HAMD and HAMA scores were not correlated with [oxy-Hb] values. CONCLUSION The PFC was significantly less active during VFT in those with MDD than in healthy controls. All brain regions, except the right DLPFC, were significantly more active in MDD patients with insomnia than in those without insomnia, suggesting that sleep quality needs to be an important indicator in fNIRS screening. In addition, there was a positive correlation between the severity of insomnia in the left VLPFC and the level of activation, suggesting a role for the left brain region in the neurophysiology of overcoming sleepiness in MDD patients. these findings may provide new ideas for the treatment of MDD patients in the future. TRIAL REGISTRATION Our experiment was registered in the China Clinical Trial Registry (registration number ChiCTR2200065622) on November 10.( The first patient was recruited in 10/11/2022.).
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Affiliation(s)
- HuaSen Xu
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - YuXing Wang
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - Yi Ming Wang
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China.
| | - YaQi Cao
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - PeiFan Li
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - YongXue Hu
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - GuangYuan Xia
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
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14
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Xie XM, Sha S, Smith RD, Liang S, Ungvari GS, Amoretti S, Wang G, Xiang YT, Vieta E. Cognitive reserve in patients with mood disorders: Validation study of the Chinese version of the cognitive reserve assessment scale in health. J Affect Disord 2023; 325:480-486. [PMID: 36621675 DOI: 10.1016/j.jad.2022.12.167] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Cognitive reserve (CR) is closely associated with cognitive and functional outcome, disease severity, progression and prognosis in psychiatric patients; however, it has not been extensively tested in mood disorders. This study examined the psychometric properties of the Cognitive Reserve Assessment Scale in Health (CRASH) in mood disorder patients. METHODS Altogether 166 subjects were recruited, 44 with major depressive disorder (MDD), 64 with bipolar disorder (BD), and 58 healthy controls. CR was assessed using the CRASH and the Cognitive Reserve Questionnaire (CRQ). RESULTS Internal consistency (Cronbach's alpha) was 0.779 for the CRASH. The Receiver Operating Characteristic (ROC) curve analysis revealed an area under the ROC curve (AUC) value of 0.73 (95 % CI: 0.647-0.809). The optimal cut-off score of 51 generated the best combination of sensitivity (0.78) and specificity (0.43) for discriminating between patients with mood disorders and healthy controls. The CRASH score was highly correlated with the CRQ score in both mood disorder patients (rs = 0.586, P < 0.001) and healthy controls (rs = 0.627, P < 0.001), indicating acceptable convergent validity for the CRASH. Within the mood disorder sample, the CRASH score was associated with functional outcomes (FAST: rs = -0.243, P = 0.011). CONCLUSIONS The CRASH is a useful tool to measure CR in mood disorder with acceptable psychometric properties and could be used in both research and clinical practice.
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Affiliation(s)
- Xiao-Meng Xie
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Robert D Smith
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Sixiang Liang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia/Graylands Hospital, Perth, Australia
| | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII, 170 Villarroel St, 08036 Barcelona, Catalonia, Spain
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII, 170 Villarroel St, 08036 Barcelona, Catalonia, Spain.
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15
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Family treatment for postpartum depression: acceptability, feasibility, and preliminary clinical outcomes. Arch Womens Ment Health 2023; 26:127-134. [PMID: 36472675 DOI: 10.1007/s00737-022-01282-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
The level of support from family members-and degree of family dysfunction-can shape the onset and course of maternal postpartum depression (PPD). In spite of this, family members are typically not included in treatments for PPD. Developing and disseminating intervention approaches that involve partners or other family members may lead to more effective treatment for perinatal women and potentially promote improved family functioning and wellbeing of multiple members of the family. To evaluate the feasibility and acceptability of a family-based treatment for PPD, we conducted an open pilot trial with 16 postpartum mother-father couples (N = 32 participants) and measured session attendance, patient satisfaction, and changes in key symptoms and functional outcomes. At the time of enrollment, mothers were 1-7 months postpartum, met criteria for major depressive disorder, and had moderate-severe symptoms of depression. Treatment involved 10-12 sessions attended by the mother along with an identified family member (all fathers) at each session. Findings provide strong support for the acceptability and feasibility of the intervention: session attendance rates were high, and participants evaluated the treatment as highly acceptable. Improvements in depression were observed among both mothers and fathers, and family functioning improved by the endpoint across several domains. Symptomatic and functional gains were sustained at follow-up. The current findings provide support for a larger randomized trial of family-based treatment for PPD.
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16
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Belli GM, Law C, Mancebo M, Eisen J, Rasmussen S, Boisseau CL. Directionality of change in obsessive compulsive disorder and depression over six years of prospective follow-up. J Psychiatr Res 2023; 157:162-167. [PMID: 36470197 PMCID: PMC9898122 DOI: 10.1016/j.jpsychires.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/18/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022]
Abstract
Major Depressive Disorder (MDD) is often comorbid with obsessive-compulsive disorder (OCD) yet little is known about the directionality of the association between OCD and depression symptoms. We aim to investigate the effect OCD symptoms has on depression symptoms and vice versa over an extended period of time. This is one of the first longitudinal studies to evaluate the relationship between OCD and depression in a large clinical sample. Participants (n = 324) were treatment-seeking adults with a primary diagnosis of OCD. OCD and depression symptoms were assessed annually over the six-year follow-up period. Random intercepts cross-lagged panel models (RI-CLPM) were conducted to compare unidirectional and bidirectional models over time. The best-fitting and most parsimonious model included paths with OCD symptoms predicting depression symptoms, but not vice versa. OCD symptom severity in a given year predicted next year depression severity. However, depression severity did not predict next-year OCD symptom severity in this sample. Our results suggest that depression severity may be secondary to OCD symptoms and treating OCD should be prioritized over treating depression.
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Affiliation(s)
- Gina M Belli
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Clara Law
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Maria Mancebo
- Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Jane Eisen
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Steven Rasmussen
- Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Christina L Boisseau
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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17
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Lynn S, Basso JC. Development and validation of the multidimensional impacts of movement scale (MIMS) for yoga, weightlifting, and running. Front Psychol 2023; 14:1078996. [PMID: 36935988 PMCID: PMC10014715 DOI: 10.3389/fpsyg.2023.1078996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/06/2023] [Indexed: 03/05/2023] Open
Abstract
Background Movement is an essential element in maintaining overall well-being, producing both physical and mental health benefits. Yoga is a mindful movement practice, with traditional yogic texts providing a framework, called the Koshas, that delineates how an intentional movement practice may impact multidimensional aspects of an individual. To date, no self-report measure examines the multifaceted ways that movement affects the individual at a physical and psychological level. Therefore, we developed the Multidimensional Impacts of Movement Scale (MIMS) by aligning ancient yogic traditions with current neuroscientific concepts. Methods MIMS was developed based on the five categories of the Koshas; 9 questions per Kosha resulted in 45 total questions. Participants (n = 103) self-identified as having yoga, running, or weightlifting as their primary movement practice, engaging in this practice at least 30 min per session, once a week, for the past 3 months. Participants engaged in their usual movement practice and then (within 2 h of their workout session) completed the MIMS along with a series of previously validated questionnaires. After a period of 2 weeks, participants completed their normal movement practice once again and took the MIMS a second time to assess test-retest reliability and Cronbach's alpha. Validity testing included convergent and divergent validity testing through Pearson's product-moment correlations and confirmatory factor analysis. Results One-hundred and three participants completed all study measures. Test-retest reliability demonstrated stability over time (r = 0.737, p < 0.001). Cronbach's alpha was between 0.775 and 0.840 for each of the factors, p < 0.001. MIMS was sensitive to confirmatory and discriminatory validity testing. Validity was also demonstrated through confirmatory factor analysis (i.e., Chi Square, Comparative Fit Index, Root Mean Square Error of Approximation). Conclusion MIMS is a valid and reliable tool to measure the multidimensional impacts of movement. The tool provides information about the effects of movement on a range of physical and psychological elements including subscales representing the body, energy, mind, intuition, and contentment. Physical activities that include aspects of mindfulness may demonstrate the most robust effects on the MIMS.
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Affiliation(s)
- Sarah Lynn
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Julia C. Basso
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at VTC, Roanoke, VA, United States
- School of Neuroscience, Virginia Tech, Blacksburg, VA, United States
- *Correspondence: Julia C. Basso,
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Huang HL, Zhu JQ, Yang LS, Wu Q, Shou DW, Chen HT, Ma J, Li YQ, Xu HM, Zhou YJ. Fecal Microbiota Transplantation Combined with a Low FODMAP Diet for the Treatment of Irritable Bowel Syndrome with Predominant Diarrhea. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:5121496. [PMID: 36187337 PMCID: PMC9519354 DOI: 10.1155/2022/5121496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/06/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Fecal microbiota transplantation (FMT) has been found to be effective in irritable bowel syndrome with predominant diarrhea (IBS-D). We conducted this study to determine the impact of a low FODMAP diet (LFD) on the gut microbiota and the efficacy of FMT in the treatment of IBS-D. METHODS A retrospective analysis of a single-arm open-label prospective study was conducted to investigate the impact of FMT alone (n = 40) and FMT+LFD (n = 40) in refractory IBS-D. The IBS-quality of life (QOL), IBS-severity scoring system (SSS), gastrointestinal symptom rating scale (GSRS), Hamilton anxiety scale (HAMA), and Hamilton depression scale (HAMD) were used to evaluate the efficacy, and partial 16S rDNA amplicon sequencing was used to profile the microbiota. RESULTS The response rates were higher in the FMT+LFD group than in the FMT group (1 mo, 3 mo, 6 mo: 70.0% vs. 55.0%, 67.5% vs. 57.5%, 62.5% vs. 27.5%, respectively). The FMT+LFD group showed significantly better improvement in IBS-QOL at 1, 3, and 6 months; IBS-SSS at 6 months; and GSRS at 1 month compared to FMT alone. Changes in HAMA and HAMD were similar in the two groups. The LFD significantly upregulated the FMT-induced microbial diversity (OTUs: 666 vs. 574, Adonis: P = 0.02) and significantly strengthened the upregulation of Bacteroides, Alistipes, and Ruminococcaceae_UCG-002 and the downregulation of Bifidobacterium. CONCLUSION An LFD enhanced the efficacy of FMT, increased the gut microbial diversity after FMT, and strengthened the inhibitory effect of FMT on conditional pathogens.
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Affiliation(s)
- Hong-Li Huang
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China
- Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou 510180, China
| | - Jia-Qi Zhu
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China
- Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou 510180, China
| | - Liu-Si Yang
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China
- Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou 510180, China
| | - Qiong Wu
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China
- Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou 510180, China
| | - Di-Wen Shou
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China
- Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou 510180, China
| | - Hui-Ting Chen
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China
- Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou 510180, China
| | - Jun Ma
- Department of Traditional Chinese Medicine, Guangzhou First People's Hospital, Guangzhou 510180, China
| | - Yong-Qiang Li
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China
- Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou 510180, China
| | - Hao-Ming Xu
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China
- Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou 510180, China
| | - Yong-Jian Zhou
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China
- Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou 510180, China
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19
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Xia K, Han Y, Zhou L, Hu S, Rao R, Shan S, Hua L. Attention impairment in patients with cervical dystonia: An attention network test study. Front Psychol 2022; 13:952567. [PMID: 35992456 PMCID: PMC9386253 DOI: 10.3389/fpsyg.2022.952567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022] Open
Abstract
Objective The purpose of this study was to investigate attentional network functional characteristics in patients with cervical dystonia (CD). Methods A total of 29 patients with CD and 26 healthy controls (HCs) were recruited. All subjects participated in the study and underwent the Attention Network Test (ANT), which evaluated the efficiencies of three independent attention networks (alerting, orienting, and executive control), as well as reaction time (RT) and accuracy. Results Significant differences between CD patients (9.86 ± 27.95 ms) and HCs (33.62 ± 23.41 ms) were observed in the alerting network (t = −3.40, p < 0.05). In contrast, the orienting network (t = 0.26, p = 0.79), executive control network (Z = −0.55, p = 0.58), total mean reaction time (t = −2.6, p = 0.79), and total accuracy rate (Z = −1.67, p = 0.09) showed no significant differences between the two groups. Conclusion Patients with CD showed a significant deficit in the alerting network. However, they did not show any deficits in the orienting or executive control network. In addition, the alerting, orienting, and executive control network functions of CD patients were all affected by the severity of torticollis, especially the alerting network function.
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Affiliation(s)
- Kun Xia
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Yongsheng Han
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
- Department of Neurology, Anhui Hospital of Integrated Traditional Chinese and Western Medicine, Hefei, China
- *Correspondence: Yongsheng Han,
| | - Lanlan Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Sheng Hu
- School of Medical Information Engineering, Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Rao Rao
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Shu Shan
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Lei Hua
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
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20
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Zhang K, Zhu Z, Shi M, Guo D, Liu Y, Bu X, Che B, Xu T, Yang P, Chen J, Xu T, He J, Zhang Y. Serum Dickkopf-1 levels and poststroke depression in ischemic stroke patients. J Affect Disord 2022; 310:337-342. [PMID: 35561890 DOI: 10.1016/j.jad.2022.05.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/07/2022] [Accepted: 05/05/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Serum Dickkopf-1 (Dkk-1) levels are associated with poor ischemic stroke prognosis, although their impact on poststroke depression (PSD) remains unclear. This study aimed to examine the association between serum Dkk-1 levels and PSD. METHODS Serum Dkk-1 levels were measured in 564 patients with ischemic stroke who participated in the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). The patients' depression status at 3 months after stroke was assessed using the Hamilton Rating Scale for Depression (HRSD-24). The HRSD score cutoff point for the diagnosis of depression was ≥8. RESULTS A total of 224 (39.72%) patients were categorized as having PSD 3 months after ischemic stroke. After adjusting for potential confounders, including age, sex, and other important covariates, elevated Dkk-1 levels were associated with an increased risk of PSD (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.14-3.22; Ptrend = 0.037). Similarly, each standard deviation (SD) increase in log-transformed Dkk-1 levels was associated with a 24% increased risk of PSD (OR, 1.24; 95% CI, 1.03-1.49; P = 0.025). Subgroup analyses further confirmed the significant associations between Dkk-1 levels and PSD. CONCLUSION Higher serum Dkk-1 levels at baseline are independently associated with an increased risk of PSD at 3 months after stroke, suggesting that Dkk-1 levels may be a promising prognostic biomarker for PSD. LIMITATIONS This study measured serum Dkk-1 levels only in the acute phase of stroke not in different phases; therefore, the relationship between dynamic changes in Dkk-1 levels and PSD could not be evaluated.
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Affiliation(s)
- Kaixin Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Zhengbao Zhu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Mengyao Shi
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Daoxia Guo
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yang Liu
- Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoqing Bu
- Department of Epidemiology, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Bizhong Che
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Tian Xu
- Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China
| | - Pinni Yang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jing Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
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21
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Zhi M, Hu L, Geng F, Shao N, Liu Y. Analysis of the Cost and Case-mix of Post-acute Stroke Patients in China Using Quantile Regression and the Decision-tree Models. Healthc Policy 2022; 15:1113-1127. [PMID: 35620736 PMCID: PMC9128830 DOI: 10.2147/rmhp.s361385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/12/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose Post-acute care is fast developing in China, yet a payment system for post-acute care has not been established. As stroke is the leading cause of mortality and disability in China, patients constitute a large share of post-acute-care patients among all hospitalized patients. This study was to identify the cost determinants and establish a case-mix classification of the post-acute care system for stroke patients in China. Patients and Methods A total of 5401 post-acute stroke patients in seven hospitals of Jinhua City from January 2018 to December 2020 were selected. Demographic characteristics, medical status, functional measures (eg, the Barthel Index, Mini-Mental State Examination, Gugging Swallowing Screen, Hamilton Depression Scale), and cost data were extracted. Generalized linear model (GLM) and quantile regression (QR) were conducted to determine the predictors of cost, and a case-mix classification model was established using the decision-tree analysis. Results The GLM regression revealed that gender, tracheostomy, complication or comorbidity (CC), activities of daily living (ADL), and cognitive impairment were the main variables significantly affecting the hospitalization expenses of post-acute stroke patients. The QR model showed that the gender, tracheostomy and CC factors had a more significant impact on per diem costs on the upper quantiles. In contrast, cognitive impairment had a more substantial effect on the lower quantiles, and ADL significantly impacted the central quantile. Using tracheostomy, CC, and ADL as node variables of the regression tree, 12 classes were generated. The case-mix classification performed reliably and robustly, as measured by the reduction in the variation statistic (RIV=0.46) and class-specific coefficients of variation (CV less than 1.0; range: 0.18–0.81). Conclusion QR has strengths in comprehensively identifying cost predictors across cost groups. Tracheostomy, CC, and ADL significantly can predict the expenses of post-acute care for stroke patients. The established case-mix classification system can inform the future payment policy of post-acute care in China.
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Affiliation(s)
- Mengjia Zhi
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100710, People’s Republic of China
| | - Linlin Hu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100710, People’s Republic of China
- Correspondence: Linlin Hu; Yuanli Liu, School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100710, People’s Republic of China, Tel/Fax +86 65105830, Email ;
| | - Fangli Geng
- Ph.D. Program in Health Policy, Harvard University Graduate School of Arts and Sciences, Cambridge, MA, USA
| | - Ningjun Shao
- Jinhua Healthcare Security Administration, Zhejiang, 321000, People’s Republic of China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100710, People’s Republic of China
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22
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Shim SH, Woo YS, Kim JS, Heo IS, Yoon HJ, Sung HM, Lee J, Bahk WM. Comparison between Atomoxetine and OROS Methylphenidate as an Adjunctive to SSRIs in Attention-deficit/Hyperactivity Disorder Adults with Comorbid Partially Responsive Major Depressive Disorder: A Head-to-head, 12-week, Randomized, Rater-blinded Clinical Trial. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2022; 20:143-153. [PMID: 35078957 PMCID: PMC8813317 DOI: 10.9758/cpn.2022.20.1.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 12/28/2022]
Abstract
Objective This study aimed to compare the efficacy and safety of atomoxetine (ATX) and OROS methylphenidate (MPH) as adjunctive to selective serotonin reuptake inhibitors (SSRIs) in adults with attention-deficit hyperactivity disorder (ADHD) with comorbid partially responsive major depressive disorder (MDD). Methods Sixty Korean adults with ADHD and comorbid partially responsive MDD were recruited in a 12-week, randomized, rater-blinded, active-controlled trial and were evenly randomized to ATX or OROS MPH treatment. Results Depressive symptoms measured using the Hamilton Depression Rating Scale and Clinically Useful Depression Outcome Scale, and ADHD symptoms measured using the Adult ADHD Self-Report Scale, as well as the Clinical Global Impression-Severity, Clinical Global Impression-Improvement, and the Sheehan Disability Scale scores were significantly improved in both groups during the 12 weeks of treatment. The changes in all outcome measures during the 12-week treatment were not significantly different between the two groups (all p > 0.05). No serious adverse events were reported and there were no significant differences in systolic and diastolic blood pressure, pulse rate, weight, or body mass index between the ATX and MPH groups. Conclusion Our findings suggest that ATX and MPH can be used as adjunctive treatments in adults with ADHD and comorbid partially responsive MDD. The efficacy and tolerability of ATX and MPH in adults with ADHD did not differ significantly. Further studies should be conducted to draw a definitive conclusion.
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Affiliation(s)
- Se-hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - In Soo Heo
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | | | - Hyung Mo Sung
- Department of Psychiatry, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea
| | - Jonghun Lee
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
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23
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Guccione C, Heilman K, Porges SW, Gentile S, Caretti V, Halaris A. Autonomic Measures in Differentiating Depressive Disorders: A Potential AID. CLINICAL NEUROPSYCHIATRY 2022; 19:29-38. [PMID: 35360468 PMCID: PMC8951165 DOI: 10.36131/cnfioritieditore20220105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Objective The present study aimed at exploring the potential utility of autonomic regulation as a useful marker in the diagnostic differentiation between unipolar and bipolar depression. Method Respiratory sinus arrhythmia (RSA), low-frequency (LF) of heart rate variability, and systolic blood pressure (SBP) were assessed in patients with bipolar depression (31) and major depressive disorder (MDD=32), and in healthy controls (HCs=32). Since bipolar depressed subjects were maintained on specific medications to manage manic/hypomanic symptoms, we explored whether mood stabilizers (atypical antipsychotics and anticonvulsants or their combinations) could independently affect the physiological parameters. Results When the autonomic measures were analyzed by a multivariate analysis of variance (MANCOVA), after controlling for BMI, the combination of variables (RSA, LF, SBP) discriminated patients with bipolar depression and MDD from HC (F(6, 178)=3.036, p=0.007, Λ=0.823, partial η2=0.093). In any case, we cannot exclude that mood stabilizers might have affected SBP values in the bipolar group. To deconstruct this multivariate effect, pairwise ANOVAs and discriminant analyses contrasted groups and documented that RSA was the primary variable distinguishing the groups. Discriminant function analyses showed that RSA had a significant discriminating weight between bipolar depressed patients and HC subjects (p<0.0005). By contrast, RSA showed a trend towards the statistical significance in discriminating between bipolar depression and MDD patients (p=0.06). Conclusions The assessment of RSA and SBP in outpatient settings might be helpful in the differential diagnosis of affective disorders.
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Affiliation(s)
- Camilla Guccione
- Department of Human Sciences, LUMSA University of Rome, Rome, Italy
| | - Keri Heilman
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Stephen W Porges
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.,Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - Simonetta Gentile
- Department of Human Sciences, LUMSA University of Rome, Rome, Italy.,Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | - Vincenzo Caretti
- Department of Human Sciences, LUMSA University of Rome, Rome, Italy
| | - Angelos Halaris
- Department of Psychiatry and Behavioral Neuroscience, Loyola University Medical Center, Maywood, IL, USA
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24
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Huang J, Zhang J, Zhang T, Wang P, Zheng Z. Increased Prefrontal Activation During Verbal Fluency Task After Repetitive Transcranial Magnetic Stimulation Treatment in Depression: A Functional Near-Infrared Spectroscopy Study. Front Psychiatry 2022; 13:876136. [PMID: 35444573 PMCID: PMC9013767 DOI: 10.3389/fpsyt.2022.876136] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/09/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Previous studies have shown the clinical effect of 2 Hz repetitive transcranial magnetic stimulation (rTMS) for depression; however, its underlying neural mechanisms are poorly understood. The aim of this study was to examine the effects of rTMS on the activity of the prefrontal cortex in patients with depression, using functional near-infrared spectroscopy (fNIRS). METHODS Forty patients with major depressive disorder (MDD) and 40 healthy controls were enrolled in this study. Patients underwent 4 weeks of 2 Hz TMS delivered to the right dorsolateral prefrontal cortex (DLPFC). fNIRS was used to measure the changes in the concentration of oxygenated hemoglobin ([oxy-Hb]) in the prefrontal cortex during a verbal fluency task (VFT) in depressed patients before and after rTMS treatment. The severity of depression was assessed using the Hamilton Rating Scale for Depression-24 item (HAMD-24). RESULTS Prior to rTMS, depressed patients exhibited significantly smaller [oxy-Hb] values in the bilateral prefrontal cortex during the VFT compared with the healthy controls. After 4 weeks of 2 Hz right DLPFC rTMS treatment, increased [oxy-Hb] values in the bilateral frontopolar prefrontal cortex (FPPFC), ventrolateral prefrontal cortex (VLPFC) and left DLPFC during the VFT were observed in depressed patients. The increased [oxy-Hb] values from baseline to post-treatment in the right VLPFC in depressed patients were positively related to the reduction of HAMD score following rTMS. CONCLUSION These findings suggest that the function of the prefrontal cortex in depressed patients was impaired and could be recovered by 2 Hz rTMS. The fNIRS-measured prefrontal activation during a cognitive task is a potential biomarker for monitoring depressed patients' treatment response to rTMS.
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Affiliation(s)
- Jiaxi Huang
- Mental Health Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Jiaqi Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Tingyu Zhang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Pu Wang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.,Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, Guangzhou, China
| | - Zhong Zheng
- Mental Health Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
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25
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Meyer JD, Perkins SL, Brower CS, Lansing JE, Slocum JA, Thomas EBK, Murray TA, Lee DC, Wade NG. Feasibility of an Exercise and CBT Intervention for Treatment of Depression: A Pilot Randomized Controlled Trial. Front Psychiatry 2022; 13:799600. [PMID: 35599775 PMCID: PMC9115753 DOI: 10.3389/fpsyt.2022.799600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/20/2022] [Indexed: 11/16/2022] Open
Abstract
Depression (DEP) is prevalent and current treatments are ineffective for many people. This pilot study's purpose was to assess the feasibility, acceptability, and plausible efficacy of an 8-week intervention employing 30 min of prescribed moderate intensity exercise ("ActiveCBT") compared to 30 min of usual activities ("CalmCBT") immediately prior to weekly online CBT sessions. Ten adults with DSM-5-diagnosed current DEP were randomized to groups and completed: an intake assessment, eight weekly CBT sessions, final assessment, and 3-month follow-up. ActiveCBT participants were prescribed 30-min of moderate exercise immediately prior to each standardized 50-min CBT session. CalmCBT participants continued with normal activities for 30 min before therapy. Questionnaires regarding DEP symptom severity (Patient Health Questionnaire-9 [PHQ-9]), between-session effectiveness (Behavioral Activation for Depression Survey [BADS], Automatic Thoughts Questionnaire [ATQ]), in-session effectiveness (Working Alliance Inventory-Short Revised [WAI]), and state anhedonia (Dimension Analog Rating Scale [DARS], Visual Analog Scale [VAS]; assessed 3 times: before Active/Calm condition, after, and after therapy) were completed each week. Therapy fidelity ratings were independently coded via a standardized codebook. The Structured Clinical Interview for DSM-5 (SCID) and Hamilton Rating Scale for Depression (HAMD) were used to assess DEP at intake, final, and 3-month follow-up. We found strong feasibility and acceptability (100% adherence, 100% retention at final visit, 74.6% therapy fidelity, and high patient satisfaction ratings). Differences between groups favoring ActiveCBT in anhedonia (DARS, Hedges' g = 0.92; VAS, g = 3.16), within- (WAI, g = 0.1.10), and between-session effectiveness (ATQ g = -0.65; BADS g = -1.40), suggest plausible efficacy of ActiveCBT for enhancing CBT. DEP rates were reduced in both groups from baseline to final (60% MDD SCID remission) and at follow up (Active: 40%; Calm: 25%). Larger and potentially quicker symptom improvement was found favoring the Active condition to the final visit (HAMD, between-group changes g = -1.33; PHQ-9, g = -0.62), with small differences remaining at follow-up (HAMD, g = -0.45; PHQ-9, g = -0.19). Exercise priming appears acceptable and plausibly efficacious for enhancing mechanisms of CBT and overall outcomes, though the present small sample precludes efficacy determinations. It appears feasible to conduct a randomized controlled trial comparing ActiveCBT to CalmCBT. Future trials evaluating this potentially promising treatment approach and mediating mechanisms are warranted.
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Affiliation(s)
- Jacob D Meyer
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Seana L Perkins
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Cassandra S Brower
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Jeni E Lansing
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Julia A Slocum
- Department of Kinesiology, Iowa State University, Ames, IA, United States.,Department of Psychology, Iowa State University, Ames, IA, United States
| | - Emily B K Thomas
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Thomas A Murray
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, United States
| | - Duck-Chul Lee
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Nathaniel G Wade
- Department of Psychology, Iowa State University, Ames, IA, United States
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Nasir M, Li F, Courley S, Olten B, Bloch MH. Meta-Analysis: Pediatric Placebo Response in Depression Trials Does Not Replicate in Anxiety and Obsessive-Compulsive Disorder Trials. J Child Adolesc Psychopharmacol 2021; 31:670-684. [PMID: 34558984 DOI: 10.1089/cap.2021.0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Placebo response has been identified as an important factor influencing the success of adult antidepressant trials, yet little research of placebo response has been conducted in pediatric populations. Understanding disorder-specific and transdiagnostic predictors of pediatric placebo response is important in designing successful child psychopharmacological trials. Methods: A PubMed search was conducted for all pediatric antidepressant randomized controlled trials treating depression, anxiety, or obsessive-compulsive disorder (OCD). A random-effects model was utilized to examine the magnitude of placebo symptom improvement using standardized mean difference (SMD) and placebo response rates. Stratified subgroup analysis was performed by diagnostic indication. Meta-regression was utilized to search possible correlates of placebo symptom improvement and placebo response rate. Results: Thirty antidepressant trials involving 2911 participants receiving placebo were included in this meta-analysis. Magnitude of placebo improvement and placebo response rates varied significantly across disorders; being greater in depression (SMD = 1.44, 95% confidence interval [CI]: 1.18 to 1.71) than anxiety disorders (SMD = 1.09, 95% CI: 0.77 to 1.41) and the lowest in OCD (SMD = 0.71, 95% CI: 0.32 to 1.12). Different predictors were associated with placebo response in different indications. Conclusions: Both the magnitude and predictors of placebo response in pediatric depression trials do not replicate across anxiety and OCD. Based on our results, across disorders, minimizing the number of sites might significantly reduce placebo improvement. In addition to these, we could potentially decrease the placebo response in depression trials by increasing the number of subjects enrolled per study site, minimizing the number of study visits and conducting the studies in the United States. Further research is needed into the predictors of placebo response in pediatric anxiety and OCD.
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Affiliation(s)
- Madeeha Nasir
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Fenghua Li
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Samantha Courley
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Baris Olten
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Michael H Bloch
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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Blood-based mitochondrial respiratory chain function in major depression. Transl Psychiatry 2021; 11:593. [PMID: 34789750 PMCID: PMC8599473 DOI: 10.1038/s41398-021-01723-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/26/2021] [Accepted: 11/02/2021] [Indexed: 12/23/2022] Open
Abstract
Mitochondrial dysfunction has been implicated in major depressive disorder (MDD). A measure of mitochondrial respiratory chain (RC) enzymatic activity-the Mitochondrial Health Index (MHI)-has previously been found to correlate with stress and emotional states in caregivers. We here report mitochondrial RC activities, mitochondrial DNA copy number (mtDNAcn), and the composite MHI in unmedicated and somatically healthy subjects with MDD (n = 47) and healthy controls (HC) (n = 11). We also explore, in a subset of the MDD sample (n = 33), whether these markers are associated with response to 8 weeks of SSRI treatment. Mitochondrial RC complexes I, II, IV, citrate synthase (CS), mtDNAcn, and the MHI were assayed in peripheral blood mononuclear cells. Treatment response was defined as >50% decrease on the 25-item Hamilton Depression Rating Scale (HRDS-25). There were no significant differences in MHI or any of the mitochondrial markers between MDD subjects and HCs. Compared to SSRI nonresponders, SSRI responders had significantly higher baseline mitochondrial content markers CS (p = 0.02) and mtDNAcn (p = 0.02), and higher complex I activity (p = 0.01). Complex II activity increased significantly over treatment, irrespective of clinical response (p = 0.03). Complex I activity decreased in responders (n = 9), but increased in nonresponders (n = 18) (group x time interaction, p = 0.02). Absolute treatment-associated change in HDRS-25 scores correlated significantly with change in complex I activity between baseline and week 8 (r = 0.47, p = 0.01). Although mitochondrial markers did not distinguish MDD from controls, they did distinguish SSRI responders from nonresponders. If larger studies validate these mitochondrial differences, they may become useful biomarkers and identify new drug targets.
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Chan SHW, Yu CH, Liu KHK, Lau C, Fung AOY, Tse S. Evaluating the emotion regulation of positive mood states among people with bipolar disorder using hierarchical clustering. World J Psychiatry 2021; 11:619-634. [PMID: 34631465 PMCID: PMC8474994 DOI: 10.5498/wjp.v11.i9.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/25/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND People with bipolar disorder (BD) frequently struggle with the recurrence of affective symptoms. However, the interplay between coping mechanism and positive mood state remains under-researched.
AIM To explore the associations among behavioral approach system (BAS) sensitivity level, coping, and positive mood states among people with BD.
METHODS Using a cross-sectional study design, 90 participants with BD were presented with four BAS-activating life event scenarios and assessed with regard to their BAS trait sensitivity, coping flexibility, and mood states. A hierarchical clustering method was used to identify different groups with different styles of coping. Multiple hierarchical regression analyses were conducted to examine the mediating and moderating roles of different components of coping on mood states.
RESULTS A three-cluster solution was found to best fit the present data set. The findings showed that a low mass of coping combined with low BAS sensitivity level protects people with BD from detrimentally accentuating mood states when they encounter BAS-activating life events. Moreover, coping flexibility is demonstrated to mediate and moderate the relationships between BAS sensitivity level and mood states. Specifically, subduing the perceived controllability and reducing the use of behavioral-activation/emotion-amplifying coping strategies could help buffer the effect of positive affect.
CONCLUSION The judicious use of coping in emotion regulation for people with BD when encountering BAS-activating life events was indicated. Practical applications and theoretical implications are highlighted.
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Affiliation(s)
- Sunny Ho-Wan Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chong Ho Yu
- School of Behavioral and Applied Science, Azusa Pacific University, Azusa, CA 91702, United States
| | - Ken Ho Kan Liu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Charlie Lau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Anna On Yee Fung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Samson Tse
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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Burton MS, Cooper AA, Mello PG, Feeny NC, Zoellner LA. Latent Profiles of Comorbid Depression as Predictors of PTSD Treatment Outcome. Behav Ther 2021; 52:970-981. [PMID: 34134835 PMCID: PMC8543494 DOI: 10.1016/j.beth.2020.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/16/2022]
Abstract
Posttraumatic stress disorder (PTSD) frequently co-occurs with major depressive disorder, and empirically supported PTSD treatments consistently improve depression. However, both diagnoses are heterogeneous and specific patterns of symptom overlap may be related to worse treatment outcome. Two hundred individuals with chronic PTSD participated in a doubly randomized preference trial comparing prolonged exposure and sertraline. Latent Profile Analysis was used to identify classes based on PTSD and depression symptoms prior to starting treatment. A three-class model best fit the data, with a high depression and PTSD severity class (distressed), a moderate depression and low PTSD avoidance class (depressive), and a low depression and high PTSD avoidance class (avoidant). The avoidant class showed the lowest rates of major depressive disorder diagnosis and transdiagnostic vulnerabilities to depression. Patients in the distressed class experienced more robust PTSD treatment response, with no differences between prolonged exposure and sertraline. These findings highlight the role of avoidance in nondepressed PTSD presentations while also demonstrating that co-occurring depression is not contraindicated in evidence-based PTSD treatment.
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Thase ME, Harrington A, Calabrese J, Montgomery S, Niu X, Patel MD. Evaluation of MADRS severity thresholds in patients with bipolar depression. J Affect Disord 2021; 286:58-63. [PMID: 33677183 DOI: 10.1016/j.jad.2021.02.043] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The Montgomery-Åsberg Depression Rating Scale (MADRS) is commonly used to assess depression symptom changes in clinical trials; however, the score itself can be difficult to interpret without clinical context. Categories of depression severity corresponding to MADRS total score have not been established for bipolar depression, which was the objective of this study. METHODS Data were pooled from 3 randomized, double-blind, placebo-controlled trials of cariprazine in patients with bipolar I depression; placebo and cariprazine arms were pooled. An anchor-based approach was used to map MADRS total score to the clinician-rated, 7-category Clinical Global Impression of Severity scale (CGI-S). Spearman's correlation coefficient was used to assess associations between MADRS total and CGI-S scores. Optimal MADRS severity thresholds for each CGI-S category was determined via Youden index using receiver operating characteristic (ROC) analyses. RESULTS Using data from 1523 patients with bipolar depression, mean MADRS total scores were positively correlated with mean CGI-S scores at week 6 (r = 0.87; P<.0001). Using ROC curves, MADRS severity thresholds corresponding to each CGI-S category were estimated with high sensitivity and specificity: 0-6 for "normal, not at all ill", 7-12 for "borderline mentally ill", 13-18 for "mildly ill", 19-23 for "moderately ill", 24-36 for "markedly ill", 37-39 for "severely ill", and ≥40 for "extremely ill". CONCLUSIONS Utilizing data from 3 clinical trials of patients with bipolar depression, MADRS severity thresholds were identified. These empirical findings may help clinicians contextualize MADRS results from bipolar clinical research and apply to their practice. TRIAL REGISTRATION clinicaltrials.gov NCT01396447, NCT02670538, NCT02670551.
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Affiliation(s)
| | | | - Joseph Calabrese
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Abstract
Wilson's disease patients with neurological symptoms have motor symptoms and cognitive deficits, including frontal executive, visuospatial processing, and memory impairments. Although the brain structural abnormalities associated with Wilson's disease have been documented, it remains largely unknown how Wilson's disease affects large-scale functional brain networks. In this study, we investigated functional brain networks in Wilson's disease. Particularly, we analyzed resting state functional magnetic resonance images of 30 Wilson's disease patients and 26 healthy controls. First, functional brain networks for each participant were extracted using an independent component analysis method. Then, a computationally efficient pattern classification method was developed to identify discriminative brain functional networks associated with Wilson's disease. Experimental results indicated that Wilson's disease patients, compared with healthy controls, had altered large-scale functional brain networks, including the dorsal anterior cingulate cortex and basal ganglia network, the middle frontal gyrus, the dorsal striatum, the inferior parietal lobule, the precuneus, the temporal pole, and the posterior lobe of cerebellum. Classification models built upon these networks distinguished between neurological WD patients and HCs with accuracy up to 86.9% (specificity: 86.7%, sensitivity: 89.7%). The classification scores were correlated with the United Wilson's Disease Rating Scale measures and durations of disease of the patients. These results suggest that Wilson's disease patients have multiple aberrant brain functional networks, and classification scores derived from these networks are associated with severity of clinical symptoms.
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Neyer S, Witthöft M, Cropley M, Pawelzik M, Lugo RG, Sütterlin S. Reduction of depressive symptoms during inpatient treatment is not associated with changes in heart rate variability. PLoS One 2021; 16:e0248686. [PMID: 33755668 PMCID: PMC7987172 DOI: 10.1371/journal.pone.0248686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 03/03/2021] [Indexed: 11/19/2022] Open
Abstract
Vagally mediated heart rate variability (HRV) is a psychophysiological indicator of mental and physical health. Limited research suggests there is reduced vagal activity and resulting lower HRV in patients with Major Depressive Disorder (MDD); however little is actually known about the association between HRV and symptoms of depression and whether the association mirrors symptom improvement following psychotherapy. The aim of this study was to investigate the association between antidepressant therapy, symptom change and HRV in 50 inpatients (68% females; 17–68 years) with a diagnosis of MDD. Severity of depressive symptoms was assessed by self-report (Beck Depression Inventory II) and the Hamilton Rating Scale of Depression. Measures of vagally mediated HRV (root mean square of successive differences and high-frequency) were assessed at multiple measurement points before and after inpatient psychotherapeutic and psychiatric treatment. Results showed an expected negative correlation between HRV and depressive symptoms at intake. Depressive symptoms improved (d = 0.84) without corresponding change in HRV, demonstrating a de-coupling between this psychophysiological indicator and symptom severity. To our knowledge, this study is the first to examine an association between HRV and depressive symptoms before and after psychotherapy. The observed de-coupling of depression and HRV, and its methodological implications for future research are discussed.
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Affiliation(s)
| | - Michael Witthöft
- Department for Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Mainz, Germany
| | - Mark Cropley
- School of Psychology, University of Surrey, Guildford, United Kingdom
| | | | - Ricardo Gregorio Lugo
- Department for Information Security and Communication Technology, Norwegian University of Science and Technology, Gjøvik, Norway
- Faculty for Health and Welfare Sciences, Østfold University College, Halden, Norway
| | - Stefan Sütterlin
- Faculty for Health and Welfare Sciences, Østfold University College, Halden, Norway
- Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
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Carrozzino D, Patierno C, Fava GA, Guidi J. The Hamilton Rating Scales for Depression: A Critical Review of Clinimetric Properties of Different Versions. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 89:133-150. [PMID: 32289809 DOI: 10.1159/000506879] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/27/2020] [Indexed: 11/19/2022]
Abstract
The format of the original Hamilton Rating Scale for Depression (HAM-D) was unstructured: only general instructions were provided for rating individual items. Over the years, a number of modified versions of the HAM-D have been proposed. They differ not only in the number of items, but also in modalities of administration. Structured versions, including item definitions, anchor points and semi-structured or structured interview questions, were developed. This comprehensive review was conducted to examine the clinimetric properties of the different versions of the HAM-D. The aim was to identify the HAM-D versions that best display the clinimetric properties of reliability, validity, and sensitivity to change. The search was conducted on MEDLINE, Scopus, Web of Science, and PubMed, and yielded a total of 35,473 citations, but only the most representative studies were included. The structured versions of the HAM-D were found to display the highest inter-rater and test-retest reliability. The Clinical Interview for Depression and the 6-item HAM-D showed the highest sensitivity in differentiating active treatment from placebo. The findings indicate that the HAM-D is a valid and sensitive clinimetric index, which should not be discarded in view of obsolete and not clinically relevant psychometric criteria. The HAM-D, however, requires an informed use: unstructured forms should be avoided and the type of HAM-D version that is selected should be specified in the registration of the study protocol and in the methods of the trial.
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Affiliation(s)
| | - Chiara Patierno
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy
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Lu Y, Qian S, Chen H, Yuan P, Zhang R, Wang A, Zhang J, Ju Z, Zhang Y, Xu T, Zhong C. Plasma soluble suppression of tumorigenicity 2 and depression after acute ischemic stroke. Eur J Neurol 2021; 28:868-876. [PMID: 33368822 DOI: 10.1111/ene.14699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND PURPOSE Soluble suppression of tumorigenicity 2 (sST2) might be related to stroke and depression, but the association of sST2 with poststroke depression (PSD) is unclear. The study aimed to prospectively assess the association between plasma sST2 levels and PSD. METHODS A total of 635 acute ischemic stroke patients with sST2 measurements from the China Antihypertensive Trial in Acute Ischemic Stroke were included in this analysis. We used the 24-item Hamilton Rating Scale for Depression to assess depression at 3 months, and PSD was defined as a score of ≥8. Logistic regression analysis was performed to estimate the risk of PSD associated with sST2, and net reclassification index (NRI) and integrated discrimination improvement (IDI) were calculated to assess the predictive value of sST2. RESULTS Two hundred fifty (39.4%) patients developed depression at 3 months after ischemic stroke. Patients with PSD had higher sST2 levels than patients without PSD (172.7 vs. 153.8 pg/ml; p = 0.003). After adjustment for age, sex, education, National Institutes of Health Stroke Scale score, and other covariates, the odds ratio for the highest quartile of sST2 compared with the lowest quartile was 1.84 (95% confidence interval, 1.10-3.08) for PSD. Adding sST2 to a conventional model notably improved risk prediction for PSD (category-free NRI = 19.34%, 95% confidence interval = 4.39%-34.28%, p = 0.017; IDI = 1.20%, 95% confidence interval = 0.25%-2.15%, p = 0.014). CONCLUSIONS Increased plasma sST2 levels in the acute phase of ischemic stroke were significantly associated with the increased risk of PSD, independently of conventional risk factors.
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Affiliation(s)
- Yaling Lu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Sifan Qian
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Haichang Chen
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Pengcheng Yuan
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Rui Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jintao Zhang
- Department of Neurology, 88th Hospital of PLA, Shandong, China
| | - Zhong Ju
- Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Tongliao, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
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Roe AL, Venkataraman A. The Safety and Efficacy of Botanicals with Nootropic Effects. Curr Neuropharmacol 2021; 19:1442-1467. [PMID: 34315377 PMCID: PMC8762178 DOI: 10.2174/1570159x19666210726150432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/23/2021] [Accepted: 07/17/2021] [Indexed: 11/22/2022] Open
Abstract
Recent estimates for the global brain health supplement category, i.e. nootropic market size, will grow to nearly $5.8 billion by 2023. Overall, nearly one-quarter (23%) of adults currently take a supplement to maintain or improve brain health or delay and reverse dementia. Not surprisingly, the use of such supplements increases with age - more than one-third of the oldest generation (ages 74 and older) takes a supplement for brain health. This widespread use is being driven by a strong desire both in the younger and older generations to enhance cognitive performance and achieve healthy aging. The most prevalent botanicals currently dominating the nootropic marketplace include Gingko biloba, American ginseng, and Bacopa monnieri. However, other botanicals that affect stress, focus, attention, and sleep have also been procured by dietary supplement companies developing products for improving both, short and long-term brain health. This review focuses on efficacy data for neuroactive botanicals targeted at improving cognitive function, stress reduction, memory, mood, attention, concentration, focus, and alertness, including Bacopa monnieri, Ginkgo biloba, Holy basil, American ginseng, Gotu kola, Lemon balm, Common and Spanish sages and spearmint. Botanicals are discussed in terms of available clinical efficacy data and current safety profiles. Data gaps are highlighted for both efficacy and safety to bring attention to unmet needs and future research.
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Affiliation(s)
- Amy L. Roe
- Personal Healthcare Division, The Procter & Gamble Company, 8700 Mason-Montgomery Road, Mason, OH, 45040, USA
| | - Arvind Venkataraman
- Personal Healthcare Division, The Procter & Gamble Company, 8700 Mason-Montgomery Road, Mason, OH, 45040, USA
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Wang X, Lei W, Liu K, Liang X, Wang Y, Huang C, Zhang T, Chen J. Implicit measure of suicidal ideation in patients with depression. DEATH STUDIES 2020; 46:1807-1813. [PMID: 33246393 DOI: 10.1080/07481187.2020.1850549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The death/suicide implicit association test (IAT) may be more resilient to accurately assess suicide risk than self-reports. We examined the IAT in 130 patients with depression and 125 healthy controls, along with self-reported suicidal ideation. IAT could differentiate patients with suicide attempts from patients without suicide attempts and controls. IAT measures were significantly correlated to explicit suicidal ideation and clinical symptoms in patients. Moreover, the IAT-symptom correlations were significant in female but not male patients. The IAT showed promise as a valid tool to estimate suicide risk in patients with depression and may be particularly useful in female patients.
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Affiliation(s)
- Xu Wang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Wei Lei
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Kezhi Liu
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xuemei Liang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yan Wang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Chaohua Huang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Tao Zhang
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jing Chen
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
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Scherf-Clavel M, Hommers L, Wurst C, Stonawski S, Deckert J, Domschke K, Unterecker S, Menke A. Higher venlafaxine serum concentrations necessary for clinical improvement? Time to re-evaluate the therapeutic reference range of venlafaxine. J Psychopharmacol 2020; 34:1105-1111. [PMID: 32669065 DOI: 10.1177/0269881120936509] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND The therapeutic reference range for venlafaxine in antidepressant treatment has been defined as 100 to 400 ng/mL. However, in an everyday setting active moiety concentrations above the therapeutic reference range were often reported. AIM The aim of this study was to re-evaluate the therapeutic reference range of venlafaxine. METHODS In-patients (⩽60 years) with major depressive episodes receiving antidepressant monotherapy with venlafaxine during routine clinical treatment were included in this observational study. Depressive symptom severity was evaluated on a weekly basis using the Hamilton Depression Rating Scale (HAMD-21), and therapeutic drug monitoring analyses were performed. Resting electrocardiograms were analyzed in week 3, week 5 and week 7 of study participation. RESULTS Clinical improvement from baseline to week 4 was significantly associated with increasing serum concentrations of the active moiety of venlafaxine (N = 23, Pearson correlation, p = 0.009), but not with the dose of venlafaxine. Patients achieving remission showed significantly higher serum concentrations than patients achieving response/non-response (Kruskal-Wallis test, p = 0.019). Moreover, in patients with serum concentrations above 400 ng/mL time to remission and time to response was significantly shorter than in patients with concentrations below 400 ng/mL (Mantel-COX test, p = 0.001; p = 0.010). QTc time was below the upper limit of a normal QTc time (450 ms) for all patients. CONCLUSION The serum concentration of the active moiety and not the dose determined the effect of venlafaxine. Shorter remission times without ECG alterations in patients with serum concentrations above the therapeutic reference range suggest a re-evaluation of the therapeutic reference range for venlafaxine in larger studies.
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Affiliation(s)
- Maike Scherf-Clavel
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Leif Hommers
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
- Interdisciplinary Center for Clinical Research, University Hospital of Würzburg, Würzburg, Germany
- Comprehensive Heart Failure Center (CHFC), University Hospital of Würzburg, Würzburg, Germany
| | - Catherina Wurst
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
- Interdisciplinary Center for Clinical Research, University Hospital of Würzburg, Würzburg, Germany
- Comprehensive Heart Failure Center (CHFC), University Hospital of Würzburg, Würzburg, Germany
| | - Saskia Stonawski
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
- Interdisciplinary Center for Clinical Research, University Hospital of Würzburg, Würzburg, Germany
- Comprehensive Heart Failure Center (CHFC), University Hospital of Würzburg, Würzburg, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Stefan Unterecker
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Andreas Menke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
- Interdisciplinary Center for Clinical Research, University Hospital of Würzburg, Würzburg, Germany
- Comprehensive Heart Failure Center (CHFC), University Hospital of Würzburg, Würzburg, Germany
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Reducing the Risk for Postpartum Depression in Adolescent Mothers: A Randomized Controlled Trial. Obstet Gynecol 2020; 136:613-621. [PMID: 32769639 DOI: 10.1097/aog.0000000000004003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To estimate the effect of an interpersonal therapy-based intervention on reducing the risk of postpartum depression in adolescents. METHODS A randomized controlled trial enrolled 250 pregnant adolescents who were aged 18 years or younger at conception. The initial sample size calculation estimated 276 participants (324 with attrition) were needed to detect a 50% reduction in risk of the primary outcome, postpartum major depressive episode, with an alpha of 0.05% and 80% power. An interim analysis by the Data Safety and Monitoring Committee informed a revision in the sample size target to 250. Participants were randomized to the intervention (n=129) or a time-matched control group (n=121) who attended sessions about pregnancy topics. Each group received five prenatal sessions and a postpartum booster session. A structured diagnostic interview was administered at baseline and specific time points through 12-months postpartum to assess for major depressive episode onset. RESULTS Participants were recruited from December 2011 to May 2016 through urban prenatal care sites in the state of Rhode Island. Of the 250 participants, 58% identified as Hispanic and 20% as black or African American. The rate of major depressive episode by 12 months postpartum was 7.0% (95% CI 2.3-11.7%) in the control group and 7.6% (95% CI 2.5-12.7%) in the intervention group, with no significant difference between groups at any time point (P=.88 by log-rank test). CONCLUSION No benefit was shown between the intervention and control groups in the rates of major depressive episode, which is likely related to a lower than predicted rate of this outcome in the control group (7.6% actual vs 25% predicted). Enhanced local community resources available to pregnant and parenting adolescents during the study period may be an explanation for this result. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT01482832.
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Cariprazine efficacy in bipolar I depression with and without concurrent manic symptoms: post hoc analysis of 3 randomized, placebo-controlled studies. CNS Spectr 2020; 25:502-510. [PMID: 31576791 PMCID: PMC7511904 DOI: 10.1017/s1092852919001287] [Citation(s) in RCA: 168] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Mixed presentations, defined by simultaneous occurrence of depressive and manic symptoms, are difficult to treat. Antidepressants, although commonly used, have weak evidence of efficacy and may increase risk of mood destabilization. The aim of this pooled post hoc analysis was to evaluate the efficacy of cariprazine in the treatment of bipolar depression with or without concurrent manic symptoms. METHODS Patients from 3 randomized, double-blind, placebo-controlled studies who met DSM-IV-TR or DSM-5 criteria for bipolar I disorder with a current major depressive episode were identified to have concurrent manic symptoms by baseline Young Mania Rating Scale total score ≥4. Efficacy was assessed in cariprazine 1.5 and 3 mg/day dose groups versus placebo; analyses included the least squares mean change from baseline to week 6 in Montgomery-Åsberg Depression Rating Scale (MADRS) total score. RESULTS Of 1383 patients randomized to treatment, 808 (58.4%) had concurrent manic symptoms. For patients with manic symptoms, mean reduction in MADRS total score from baseline to week 6 was significantly greater for both cariprazine 1.5 and 3 mg/day compared with placebo, with least squares mean differences (LSMDs) versus placebo of -2.5 (p = .0033) and -2.9 (p = .0010), respectively; for patients without manic symptoms, the LSMD was significant for 1.5 mg/day (-3.3; p = .0008), but not for 3 mg/day (-1.9; p = .0562). CONCLUSION The results of this post hoc analysis suggest that cariprazine may be an appropriate treatment option for patients with bipolar I depression with or without manic symptoms, with higher doses potentially more effective in patients with manic symptoms.
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Brave Heart MYH, Chase J, Myers O, Elkins J, Skipper B, Schmitt C, Mootz J, Waldorf VA. Iwankapiya American Indian pilot clinical trial: Historical trauma and group interpersonal psychotherapy. Psychotherapy (Chic) 2020; 57:184-196. [PMID: 31789541 PMCID: PMC8216771 DOI: 10.1037/pst0000267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
American Indians face pervasive trauma exposure, collective histories of communal suffering, and elevated risk for depression and posttraumatic stress disorder. In addition to socioeconomic barriers, access to culturally responsive treatment is limited, which may compromise treatment engagement. The Iwankapiya study piloted the Historical Trauma and Unresolved Grief Intervention (HTUG), combined with Group Interpersonal Psychotherapy (IPT), to reduce symptoms of depression and related trauma and grief. The study hypothesized that HTUG + IPT would lead to greater group engagement and decreased depression and related symptoms compared with IPT-Only. American Indian adults (n = 52) were randomized into one of two 12-session interventions, HTUG + IPT or IPT-Only, at two tribal sites: one Northern Plains reservation (n = 26) and one Southwest urban clinic (n = 26). Standardized measures assessed depression, posttraumatic stress disorder, grief, trauma, and substance use. Data were collected at screening, baseline, end of intervention, and 8 weeks postintervention; depression and group engagement measures were also collected at Weeks 4 and 8 of the intervention. Depression scores significantly decreased for both treatments, but there were no significant differences in depression between the two groups: IPT-Only (30.2 ± 6.4 at baseline to 16.7 ± 12.1 at follow-up) and HTUG + IPT (30.2 ± 8.1 at baseline to 19.9 ± 8.8 at follow-up). However, HTUG + IPT participants demonstrated significantly greater group engagement. Postintervention, clinicians expressed preference for HTUG + IPT based upon qualitative observations of greater perceived gains among participants. Given the degree of trauma exposure in tribal communities, these findings in a relatively small sample suggest HTUG should be further examined in context of treatment engagement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | - Orrin Myers
- Department of Family and Community Medicine, University of New Mexico
| | | | - Betty Skipper
- Department of Family and Community Medicine, University of New Mexico
| | - Cheryl Schmitt
- Department of Family and Community Medicine, University of New Mexico
| | - Jennifer Mootz
- New York State Psychiatric Institute, Columbia University
| | - V Ann Waldorf
- Department of Psychiatry and Behavioral Sciences, University of New Mexico
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Adler G, Chwalek K, Jajcevic A. Six-month course of mild cognitive impairment and affective symptoms in late-life depression. Eur Psychiatry 2020; 19:502-5. [PMID: 15589711 DOI: 10.1016/j.eurpsy.2004.09.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2003] [Revised: 04/05/2004] [Accepted: 08/25/2004] [Indexed: 11/30/2022] Open
Abstract
AbstractMild cognitive impairment (MCI) is frequent in patients with late-life depression. Previous studies indicate that cognitive performance in these patients is not or only marginally improved when they recover from depression. However, recovery from cognitive impairments due to depression may have a longer time course than recovery from affective symptoms. In a group of 34 elderly depressed patients (mean age: 73.4 years) admitted to a gerontopsychiatric day-clinic, severity of depression and cognitive performance were assessed before the initiation of treatment and were reassessed 6 months later. At admission, 18 of 34 patients (53%) fulfilled the criteria for MCI, with a preponderance of impairments in short-term memory and visuospatial capabilities. At the 6-month follow-up, cognitive performance had not significantly improved for the entire group; 12 of 27 patients (44%) still were fulfilling the criteria for MCI. No relationships could be ascertained between cognitive impairment or functional level and severity or course of depression. Patients with diurnal variations of the depressive symptomatology were less likely to fully recover from depression.
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Affiliation(s)
- Georg Adler
- Altentagesklinik, Zentralinstitut für Seelische Gesundheit, J5, 68159 Mannheim, Germany.
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The association of cognitive deficits with mental and physical Quality of Life in Major Depressive Disorder. Compr Psychiatry 2020; 97:152147. [PMID: 31838296 DOI: 10.1016/j.comppsych.2019.152147] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 11/09/2019] [Accepted: 11/10/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Patients with Major Depressive Disorder experience significantly reduced subjective Quality of Life (QOL), including impaired social and emotional functioning and greater fatigue and physical pain. Mounting evidence suggests that cognitive dysfunction (e.g., deficits in memory, executive function) contributes independently to the onset of reduced QOL, however the domain-specific nature of this relationship has not been investigated. The present study examined the relationship between specific cognitive domains (e.g., attention, spatial cognition) and specific deficits in mental and physical QOL in subjects with lifetime MDD, as well as acutely depressed, remitted and healthy participants. METHODS Data were obtained (N = 387) from the Cognitive Function and Mood Study (COFAMS), a cross-sectional study of emotional, functional and cognitive status in individuals with mood disorders. Participants' (acutely depressed n = 93, remitted n = 170, and healthy control n = 124) QOL was assessed with the 36-Item Short Form Health Survey (SF-36) and cognitive functioning was evaluated with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Colorado Assessment Tests (CATs) and the Psychology Experiment Building Language (PEBL). RESULTS Analyses revealed that poor immediate and delayed memory were associated with reduced mental QOL in individuals with lifetime MDD, acutely depressed, and healthy controls. In contrast, cognitive functioning was not associated with mental QOL in remitted patients. No cognitive domains were significantly related to physical QOL in any participant group. CONCLUSIONS The result suggests that deficits in immediate and delayed memory may contribute to reduced mental QOL in acute MDD, whereas cognition does not appear to play a role in physical QOL. Memory should be considered important cognitive treatment targets for MDD patients suffering specifically from reduced mental QOL.
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Schmit MK, Oller ML, Tapia‐Fuselier JL, Schmit EL. A Holistic Client Functioning Profile Comparison of People With Serious Mental Illness. JOURNAL OF COUNSELING AND DEVELOPMENT 2020. [DOI: 10.1002/jcad.12295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | - Marianna L. Oller
- Department of Counseling and Higher Education, University of North Texas
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Andrade-González N, Hernández-Gómez A, Álvarez-Sesmero S, Gutiérrez-Rojas L, Vieta E, Reinares M, Lahera G. The influence of the working alliance on the treatment and outcomes of patients with bipolar disorder: A systematic review. J Affect Disord 2020; 260:263-271. [PMID: 31521862 DOI: 10.1016/j.jad.2019.09.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/22/2019] [Accepted: 09/02/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The working alliance plays an essential role in the treatment of patients with different diseases. However, this variable has received little attention in patients with bipolar disorder. Therefore, this systematic review aimed to examine the working alliance's influence on these patients' treatment outcomes, analyze its role in the adherence to pharmacotherapy, and identify the variables that are related to a good working alliance. METHODS PubMed, PsycINFO, and Web of Science databases were searched until January 5, 2018 using a predetermined search strategy. Then, a formal process of study selection and data extraction was conducted. RESULTS Seven articles fulfilled the inclusion criteria and they included a total of 3,985 patients with bipolar disorder type I and II. Although the working alliance's ability to predict the duration and presence of manic and depressive symptoms is unclear, a good working alliance facilitates the adherence to pharmacological treatment. In addition, good social support for patients is associated with a strong working alliance. LIMITATIONS The selected studies used different definitions and measures of the working alliance and adherence, and most used self-reports to assess the working alliance. Furthermore, the relationships found among the variables were correlational. CONCLUSIONS The working alliance can play an important role in adjunctive psychological therapies and in pharmacological and somatic treatments for patients with bipolar disorder. However, the number of studies on working alliance in bipolar disorder is rather limited and there is methodological heterogeneity between the studies.
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Affiliation(s)
- Nelson Andrade-González
- Relational Processes and Psychotherapy Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | | | | | | | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - María Reinares
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Guillermo Lahera
- Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain; IRyCIS, CIBERSAM, Madrid, Spain.
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Parade SH, Wong K, Belair R, Dickstein S, Seifer R. Infant sleep moderates the effect of infant temperament on maternal depressive symptoms, maternal sensitivity, and family functioning. Infant Behav Dev 2019; 57:101343. [PMID: 31634703 PMCID: PMC11170666 DOI: 10.1016/j.infbeh.2019.101343] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 04/26/2019] [Accepted: 07/19/2019] [Indexed: 12/01/2022]
Abstract
Observed infant temperamental difficulty and infant sleep efficiency and sleep variability were examined as predictors of maternal depressive symptoms, maternal sensitivity, and family functioning. Eight observations at 8-months postpartum were used to assess infant temperament, and actigraphy was used to measure infant sleep for 1-week at the time of the 8-month assessment. Structured clinical interviews were used to assess maternal depressive symptoms between 5 and 12 months postpartum and at 15 months postpartum, and observational assessments were used to assess maternal sensitivity and family functioning at 15 months postpartum. Variability in infant sleep moderated the effect of infant temperament on maternal depressive symptoms, maternal sensitivity, and family functioning. Infant temperament was positively associated with maternal depressive symptoms when variability in infant sleep efficiency was high, but not when variability in infant sleep efficiency was low. Likewise, infant temperament was negatively associated with maternal sensitivity and family functioning when variability in infant sleep efficiency was high, but not when variability in infant sleep efficiency was low. Results underscore the importance of infant sleep for maternal and family health.
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Affiliation(s)
- Stephanie H Parade
- E. P. Bradley Hospital and the Warren Alpert Medical School of Brown University, United States.
| | - Kristyn Wong
- E. P. Bradley Hospital and the Warren Alpert Medical School of Brown University, United States
| | - Renee Belair
- E. P. Bradley Hospital and the Warren Alpert Medical School of Brown University, United States
| | - Susan Dickstein
- E. P. Bradley Hospital and the Warren Alpert Medical School of Brown University, United States
| | - Ronald Seifer
- E. P. Bradley Hospital and the Warren Alpert Medical School of Brown University, United States
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Peckham AD, Johnson SL, Swerdlow BA. Working memory interacts with emotion regulation to predict symptoms of mania. Psychiatry Res 2019; 281:112551. [PMID: 31525674 PMCID: PMC6988851 DOI: 10.1016/j.psychres.2019.112551] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 08/06/2019] [Accepted: 08/31/2019] [Indexed: 01/29/2023]
Abstract
Although neurocognitive deficits and emotion regulation are closely linked within unipolar depression, little research has tested links between these two variables within bipolar disorder. The present study tested whether working memory is related to individual differences in emotion regulation strategies in bipolar disorder and whether working memory and emotion regulation can explain variability in symptoms over time. Fifty-nine euthymic adults with bipolar I disorder completed a working memory span task, symptom interviews assessing depression and mania, and questionnaires assessing brooding rumination, reappraisal, and suppression. At baseline, working memory was unrelated to emotion regulation. Symptom interviews were repeated at six months (n = 41) and 12 months (n = 36) follow-up. At 12 months, baseline working memory significantly interacted with baseline suppression to predict higher mania. Tests of simple slopes showed that at lower working memory levels, low use of suppression was associated with significantly greater mania symptoms. These results help to clarify previous inconsistent findings regarding cognitive functioning and emotion regulation strategies in bipolar disorder, suggesting that deficits in both domains combine to predict outcomes.
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Affiliation(s)
- Andrew D. Peckham
- Corresponding Author. Andrew Peckham is now affiliated with Harvard Medical School and McLean Hospital, 115 Mill Street, Mail Stop 113, Belmont, MA, 02478. Phone: 617-855-2946;
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Painter JM, Mote J, Peckham AD, Lee EH, Campellone TR, Pearlstein JG, Morgan S, Kring AM, Johnson SL, Moskowitz JT. A positive emotion regulation intervention for bipolar I disorder: Treatment development and initial outcomes. Gen Hosp Psychiatry 2019; 61:96-103. [PMID: 31439286 PMCID: PMC6861691 DOI: 10.1016/j.genhosppsych.2019.07.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Dysfunction in positive affect is a defining symptom of bipolar I disorder (BD), both during and between mood episodes. We hypothesize that helping people with BD learn skills to create balance in their affective experiences by engaging in strategies that increase low activation positive emotion (LAP; e.g., relaxation) could help to improve well-being during periods of symptom remission. We discuss the development and preliminary outcomes of a positive emotion regulation (PER) group treatment for people with BD, designed as a supplement to pharmacological treatment. METHOD The Learning Affective Understanding for a Rich Emotional Life (LAUREL) intervention is a group-based intervention covering 10 empirically supported skills designed to increase LAP. Sixteen people with BD enrolled in the LAUREL intervention and twelve completed baseline and post-intervention assessments. RESULTS Participants who completed the study (n = 12) attended the majority of groups (87.96%) and reported practicing skills, on average, 16 times a week. We were unable to detect significant differences in mania symptoms following engagement in this PER intervention. Finally, participants reported increases in several areas associated with well-being post-intervention, including mindfulness, reappraisal, and self-compassion. CONCLUSION This study provides a theoretical framework and preliminary support for a PER intervention for BD.
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Affiliation(s)
- Janelle M Painter
- University of California, Berkeley, Department of Psychology, United States of America.
| | - Jasmine Mote
- University of California, Berkeley, Department of Psychology, United States of America.
| | - Andrew D Peckham
- University of California, Berkeley, Department of Psychology, United States of America.
| | - Erica H Lee
- University of California, Berkeley, Department of Psychology, United States of America.
| | - Timothy R Campellone
- University of California, Berkeley, Department of Psychology, United States of America.
| | - Jennifer G Pearlstein
- University of California, Berkeley, Department of Psychology, United States of America.
| | - Stefana Morgan
- University of California, San Francisco, Department of Psychiatry, United States of America.
| | - Ann M Kring
- University of California, Berkeley, Department of Psychology, United States of America.
| | - Sheri L Johnson
- University of California, Berkeley, Department of Psychology, United States of America.
| | - Judith T Moskowitz
- University of California, San Francisco, Department of Psychiatry, United States of America.
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Che B, Zhong C, Ge J, Li R, Zhu Z, Bu X, Xu T, Ju Z, Liu J, Zhang J, Chen J, Zhang Y, He J. Serum Matrix Metalloproteinase-9 Is Associated With Depression After Acute Ischemic Stroke. Circ J 2019; 83:2303-2311. [PMID: 31564697 DOI: 10.1253/circj.cj-19-0376] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Matrix metalloproteinase-9 (MMP-9), a key determinant of extracellular matrix degradation, might cause cerebral damage after stroke and be involved in the development of depressive symptoms. This study aimed to evaluate the association of serum MMP-9 levels and post-stroke depression (PSD). METHODS AND RESULTS Serum MMP-9 levels were determined in 558 acute ischemic stroke patients from 7 hospitals comprising the China Antihypertensive Trial in Acute Ischemic Stroke. We assessed depression status using the 24-item Hamilton Depression Rating Scale and defined PSD as a cutoff score of 8. Logistic regression was performed to estimate the risk of PSD associated with serum MMP-9. Discrimination and reclassification for PSD by MMP-9 were analyzed. A total of 222 (39.8%) stroke patients were categorized as PSD within 3 months. Serum MMP-9 concentrations were higher among PSD patients than those without PSD (658.8 vs. 485.7 ng/mL; P<0.001). The multiple-adjusted odds ratio (95% confidence interval) for the highest MMP-9 quartile compared with the lowest quartile was 4.36 (2.49-7.65) for PSD, and 1 standard deviation higher log-MMP-9 was associated with 68% (37-106%) increased odds of PSD. Adding MMP-9 to the conventional risk factors model substantially improved discrimination and reclassification for PSD (all P<0.05). CONCLUSIONS Elevated serum MMP-9 levels in the acute phase of ischemic stroke were associated with increased risk of PSD, suggesting an important prognostic role of MMP-9 for PSD.
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Affiliation(s)
- Bizhong Che
- School of Public Health, Medical College of Soochow University
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University
| | - Chongke Zhong
- School of Public Health, Medical College of Soochow University
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University
| | - Jinzhuo Ge
- School of Public Health, Medical College of Soochow University
| | - Ruyi Li
- School of Public Health, Medical College of Soochow University
| | - Zhengbao Zhu
- School of Public Health, Medical College of Soochow University
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine
| | - Xiaoqing Bu
- School of Public Health, Medical College of Soochow University
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University
- Department of Epidemiology, School of Public Health, Chongqing Medical University
| | - Tan Xu
- School of Public Health, Medical College of Soochow University
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University
| | - Zhong Ju
- Department of Neurology, Kerqin District First People's Hospital of Tongliao City
| | - Jiale Liu
- Department of Neurology, Jilin Central Hospital
| | - Jintao Zhang
- Department of Neurology, the 88th Hospital of PLA
| | - Jing Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine
- Department of Medicine, Tulane University School of Medicine
| | - Yonghong Zhang
- School of Public Health, Medical College of Soochow University
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine
- Department of Medicine, Tulane University School of Medicine
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Johnson SL, Mehta H, Ketter TA, Gotlib IH, Knutson B. Neural responses to monetary incentives in bipolar disorder. NEUROIMAGE-CLINICAL 2019; 24:102018. [PMID: 31670069 PMCID: PMC6831914 DOI: 10.1016/j.nicl.2019.102018] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 08/18/2019] [Accepted: 09/27/2019] [Indexed: 11/16/2022]
Abstract
Although behavioral sensitivity to reward predicts the onset and course of mania in bipolar disorder, the evidence for neural abnormalities in reward processing in bipolar disorder is mixed. To probe neural responsiveness to anticipated and received rewards in the context of bipolar disorder, we scanned individuals with remitted bipolar I disorder (n = 24) and well-matched controls (n = 24; matched for age and gender) using Functional Magnetic Resonance Imaging (FMRI) during a Monetary Incentive Delay (MID) task. Relative to controls, the bipolar group showed reduced NAcc activity during anticipation of gains. Across groups, this blunting correlated with individual differences in impulsive responses to positive emotions (Positive Urgency), which statistically accounted for the association of blunted NAcc activity with bipolar diagnosis. These results suggest that blunted NAcc responses during gain anticipation in the context of bipolar disorder may reflect individual differences in Positive Urgency. These findings may help resolve discrepancies in the literature on neural responses to reward in bipolar disorder, and clarify the relationship between brain activity and the propensity to experience manic episodes.
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Affiliation(s)
- Sheri L Johnson
- Department of Psychology, University of California, Berkeley, CA, United States
| | - Hershel Mehta
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Terence A Ketter
- Department of Psychiatry, Stanford University, Stanford, CA, United States
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Brian Knutson
- Department of Psychology, Stanford University, Stanford, CA, United States.
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Abstract
OBJECTIVE Serotonin reuptake inhibitors (SRIs) are the first-line pharmacotherapy for body dysmorphic disorder (BDD), a common and severe disorder. However, predictors and correlates of treatment response are not well understood. A closer examination of baseline personality dimensions and disorders and of changes in personality during SRI treatment is needed to advance knowledge of this clinically important issue. METHOD We conducted a secondary analysis of data from a pharmacotherapy relapse prevention trial of the SRI escitalopram in adults with BDD to examine personality dimensions and traits, as well as whether these variables predict and correlate with treatment response. A total of 65 participants with BDD completed the Revised NEO Personality Inventory (NEO PI-R) before starting open-label treatment with escitalopram and 42 participants completed the NEO PI-R after treatment. RESULTS At baseline, participants with BDD displayed higher levels of neuroticism and lower levels of extraversion than a normed reference group. Higher baseline neuroticism was a significant predictor of nonresponse to escitalopram treatment, even when baseline depression severity was controlled for. Changes in neuroticism were not associated with treatment response. CONCLUSION Our findings underscore the relationship between BDD and neuroticism, and they suggest a link between neuroticism and SRI treatment response.
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