The mRNA expression levels of GABAA receptor α1 and α2 subunits in patients with major depressive disorder during onset and remission.

OBJECTIVE: We aimed to investigate the expression levels of GABA and GABAA receptor α1 and α2 subunits in patients with major depressive disorder (MDD) during onset and remission. MATERIALS AND METHODS: 48 patients with MDD during onset and 45 patients with MDD during remission who were treated in our university were selected. Moreover, the control group included 46 healthy volunteers recruited in the community. The depression and anxiety symptoms were assessed by Hamilton Depression (HAMD) Scale and Hamilton Anxiety (HAMA) Scale. ELISA was used to determine the serum GABA levels. The mRNA expression of GABAA receptor α1 and α2 subunits in peripheral blood were detected by RT-PCR. RESULTS: The expression levels of serum GABA and of GABAA receptor α1 and α2 subunits in MDD depression attack group were notably decreased in comparison with those in MDD remission group and control group ((4.10 ± 0.73) v.s. (5.91 ± 1.25) and (5.83 ± 1.17) umol/L, F = 5.61, p < 0.001; (0.53 ± 0.32) v.s. (0.91 ± 0.18) and (0.93 ± 0.21), F = 8.37, p < 0.001; (1.45 ± 0.86) v.s. (2.33 ± 1.49) and (2.28 ± 1.50), F = 8.23, p < 0.001). However, there were no marked difference in the levels of these three indices between the MDD remission group and the control group (p > 0.05). Serum GABA levels were negatively correlated with HAMA total score (r = -0.34, p = 0.02), HAMD total score (r = -0.46, p = 0.01) and depression core symptom score (r = -0.32, p = 0.03). CONCLUSIONS: During the onset of MDD, there may be GABA neuronal dysfunction and abnormal expression of GABAA receptor subunits, and those changes showed a state change, which gradually returned to normal during remission.

A PET imaging study of the brain changes of glucose metabolism in patients with temporal lobe epilepsy and depressive disorder.

BACKGROUND: This study aims to compare the difference of the brain changes of glucose metabolism between temporal lobe epilepsy patients (TLE) with major depressive disorder and temporal TLE without major depressive disorder. METHODS: A total of 24 TLE patients, who met the inclusion criteria of our hospital, were enrolled in this study. They were divided into a TLE with depression group (n = 11) and a TLE without depression group (n = 13), according to the results of the HAMD-24 Scale. Two groups patients were examined using 18F-FDG PET brain imaging. RESULTS: The low metabolic regions of the TLE with depression group were mainly found in the left frontal lobe, temporal lobe and fusiform gyrus, while the high metabolic regions of the TLE with depression group were mainly located in the right frontal lobe, visual joint cortex and superior posterior cingulate cortex. Both of the TLE groups had high metabolic compensation in the non-epileptic area during the interictal period. CONCLUSIONS: There is an uptake difference of 18F-FDG between TLE patients with depression and TLE patients without depression in multiple encephalic regions.

Plasma neuropeptide Y levels in Chinese patients with primary insomnia.

PURPOSE: The present study aimed to explore the possible difference in plasma neuropeptide Y (NPY) level between patients with primary insomnia and healthy normal sleepers. METHODS: The sample comprised 42 patients with primary insomnia and 38 age- and sex-matched healthy controls. Clinical measures, including the Pittsburgh Sleep Quality Index (PSQI), State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (revised edition, BDI-R), were recorded, respectively. Morning fasting plasma NPY levels of all participants were determined by using enzyme-linked immunosorbent assay (ELISA). Student's t-test or chi-square test was used to compare the differences in demographic and clinical factors and scores of psychometric assessments between groups. Bivariate correlation test was used to analyze the relationship between NPY level and factors, such as age, body mass index (BMI), PSQI, STAI, and BDI-R score. Analysis of covariance (ANCOVA) was used to study the difference of plasma NPY level between two groups with adjustment for age, sex, BMI, STAI, and BDI-R total score. RESULTS: We found that morning plasma NPY levels in patients with primary insomnia were significantly lower than those in the normal controls (5.11 ± 2.87 vs. 7.01 ± 3.44 ng/ml, p = 0.009). The difference in plasma NPY level persisted even after adjustment for age, sex, BMI, STAI, and BDI-R total score (p = 0.026). For all subjects, plasma NPY level was found decreasing significantly with age (r = -0.232, p = 0.038). In addition, there was a trend that plasma NPY level was negatively associated with PSQI total score (r = -0.209, p = 0.063). CONCLUSIONS: Our findings suggest that NPY system may involve in the pathophysiological process of primary insomnia. Further studies are warranted to determine the causal relationship between low plasma NPY level and primary insomnia disorder.

The effect of neuroendocrine abnormalities on the risk of psychiatric readmission after hospitalization for bipolar disorder: A retrospective study.

BACKGROUND: The correlation between the endocrine system and bipolar disorder(BD) has been well recognized, yet the influence of neuroendocrine hormones on readmission risk post-hospitalization for BD remains largely unexplored. This retrospective cohort study was to scrutinize the impact of neuroendocrine functionality on the readmission of patients with BD post-hospitalization for mental disorders. METHODS: The dataset was derived from the electronic medical records of the First Affiliated Hospital of Jinan University in Guangzhou, China. Both univariate and multivariate logistic regression analysis were conducted on all patients hospitalized for BD, and from 1 January 2017 to October 2022. RESULTS: Of the 1110 eligible patients, 83 and 141 patients experienced psychiatric readmissions within 90 and 180 days post-discharge, respectively. Multivariate analysis revealed that high serum TSH levels (aOR = 1.079; 95%CI = 1.003-1.160) and thyroid disease comorbidities (aOR = 2.899; 95%CI = 1.303-6.452) were independently correlated with the risk of 90-day readmission; while increased serum TSH levels (aOR = 1.179; 95%CI = 1.081-1.287) represented a risk factor for 180-day readmission. These results indicate that high serum TSH levels and thyroid disease comorbidities may contribute to an elevated readmission risk in patients with BD following hospitalization. CONCLUSION: Routinely evaluating and intervening in thyroid function is crucial in the treatment of BD, as it may aid in preventing re-hospitalization.

Impairment of GABA inhibition in insomnia disorders: Evidence from the peripheral blood system.

Aim: To explore the change characteristics and related factors of various indexes of GABAergic system in peripheral blood of patients with insomnia disorder. Methods: In this study, a total of 30 patients who met the DSM-5 diagnostic criteria for insomnia disorder and 30 normal controls were included. All subjects had a structured clinical interview with the Brief International Neuropsychiatric Disorder Interview, and PSQI was used to evaluate the sleep status of the subjects. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum γ-aminobutyric acid (GABA), and RT-PCR was used to detect GABAA receptor α1 and α2 subunit mRNA. All data were statistically analyzed using SPSS 23.0. Results: Compared with the normal control group, the mRNA levels of GABAA receptor α1 and α2 subunits in the insomnia disorder group were significantly lower, but there was no significant difference in the serum GABA levels between the two groups. And in the insomnia disorder group, there was no significant correlation between the GABA levels and the mRNA expression levels of α1 and α2 subunits of GABAA receptors. Although no significant correlation was found between PSQI and serum levels of these two subunit mRNAs, its component factors sleep quality and sleep time were negatively correlated with GABAA receptor α1 subunit mRNA levels, and daytime function was inversely correlated with GABAA receptor α2 subunit mRNA levels. Conclusion: The inhibitory function of serum GABA in patients with insomnia may be impaired, and the decreased expression levels of GABAA receptor α1 and α2 subunit mRNA may become a reliable indicator of insomnia disorder.

Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder.

Background: Non-suicidal self-injury (NSSI) is commonly seen in adolescents with depression and is a high-risk factor leading to suicide. The psychological mechanisms underlying depression with NSSI are still unclear. The purpose of this study was to explore the differences in personality traits, defensive styles, and borderline symptoms among first-episode youth patients with depression and self-injury compared with patients with depression without self-injury and healthy populations. Methods: The current study recruited 188 participants, including 64 patients with depression and NSSI, 60 patients with depression without NSSI, and 64 healthy control subjects. Eysenck Personality Questionnaire, the Defense Style Questionnaire, the short version of the Borderline Symptom List, the Beck Depression Inventory, and the Ottawa Self-Injury Inventory were used to assess all participants. Results: Patients with depression and NSSI showed more psychoticism than patients with depression without NSSI and healthy control subjects. Patients with depression and NSSI presented more intermediate defense styles than healthy control subjects. In the patients with depression and NSSI group, the frequency of self-injury in the last week was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. Further regression analysis showed that EPQ-psychoticism and depressive symptoms were independent risk factors for NSSI in patients with depression. Conclusion: This study found that patients with depression and self-injury presented more neuroticism, introversion, EPQ-psychoticism, immature defenses, intermediate defenses, and borderline symptoms. Self-injury frequency was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. EPQ-Psychoticism and depressive symptoms are risk factors for predicting non-suicidal self-injury in patients with depression.

Efficacy and Safety of Pulse Magnetic Therapy System in Insomnia Disorder: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial.

OBJECTIVE: This study's objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. METHODS: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. RESULTS: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%-79.0%), 75.0% (95% CI: 64.1%-83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. CONCLUSION: PMTS is safe and effective in improving insomnia disorders.