Expansion of CD4 T Lymphocytes Expressing Interleukin 17 and Tumor Necrosis Factor in Patients with Major Depressive Disorder.

BACKGROUND: We have investigated the distribution of the Th1, Th2 and Th17 subsets in circulating CD4+ T lymphocytes and their naïve (TN), effector (TE), central (TCM) and effector memory (TEM) activation/differentiation stages in patients with major depressive disorder (MDD). METHODS: Thirty MDD patients and 30 healthy controls were studied. The counts of circulating CD4+ T lymphocytes and their distribution on the TN, TE, TCM and TEM activation/differentiation stages were analyzed by polychromatic flow cytometry. The intracytoplasmic interferon gamma (IFNγ), interleukin (IL)-4, IL-17A and tumor necrosis factor alpha (TNF-alpha) and membrane CD28 expression were also measured. The serum IFNγ, IL-4, Il-17A and TNF-alpha were measured by Luminex, respectively. RESULTS: MDD patients had normal counts of CD4+ T lymphocytes and of their TN, TCM and TEM subsets but increased number and percentage of TE CD4+ subset. CD4+ T lymphocytes had significantly enhanced percentage of cells that express IL-17 and TNF-alpha explained by the expansions found in the TN, TCM and, TEM and TCM, TEM and TE activation/differentiation stages, respectively. A selective increase in the percentages of TCM and TEM expressing IFNγ was also observed. We found a significant correlation between the percentages of CD4+ T lymphocytes expressing IFNγ and TNF-alpha in these patients. MDD patients showed increased serum levels of IL-17 and TNF-alpha, but normal IFNγ and IL-4 concentration. LIMITATIONS: the cross-sectional nature of the study could be considered a limitation. CONCLUSIONS: MDD patients have abnormal circulating CD4+ T lymphocytes with expansion of the IL-17 and TNF-alpha expressing cells as well as increased levels of circulating IL-17 and TNF-alpha.

A Structural Equation Model of Achievement Emotions, Coping Strategies and Engagement-Burnout in Undergraduate Students: A Possible Underlying Mechanism in Facets of Perfectionism.

Achievement emotions that the university student experiences in the learning process can be significant in facilitating or interfering with learning. The present research looked for linear and predictive relations between university students' achievement emotions, coping strategies, and engagement-burnout, in three different learning situations (classroom, study time, and testing). Hypotheses were identified for a possible model that would analyze the two facets of perfectionism based on these relations. In the case of perfectionistic strivings, the test hypothesis was that positive emotions would predispose the use of problem-focused coping strategies and an emotional state of engagement; in the case of perfectionistic concerns, however, negative emotions would predispose the use of emotion-focused strategies and a state of burnout. A total of 654 university students participated in the study, using an online tool to complete validated questionnaires on the three study variables. All students provided informed consent and corresponding permissions. Given the ex-post facto linear design, the predictions could be verified for each situation by means of logistic regression analyses and Structural Equations Models (SEM). Empirical results lent support, in varying degree, to the proposed theoretical relations. The testing situation was of particular interest. We discuss implications for perfectionism research and for the practice of prevention, education and health care in the university setting.

DSM-5 Y CIE-11: La deconstrucción de los trastornos somatomorfos. Enero 2020 / DSM-5 & CIE-11: the deconstruction of somatoform diseases. January 2020

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Abnormal Distribution and Function of Circulating Monocytes and Enhanced Bacterial Translocation in Major Depressive Disorder.

Introduction: Major depressive disorder (MDD) patients experience a systemic inflammatory stage. Monocytes play an important role in innate inflammatory responses and may be modulated by bacterial translocation. Our aim was to investigate the subset distribution and function of circulating monocytes, levels of proinflammatory cytokines, gut barrier damage, and bacterial translocation in MDD patients. Methods: Twenty-two MDD patients without concomitant diseases and 14 sex- and age-matched healthy controls were studied. The levels of circulating CD14++CD16- (classical), CD14++CD16++ (intermediate) and CD14-CD16++ (nonclassical) monocytes and the intracytoplasmic tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, IL-6, and IL-10 expression in the presence or absence of lipopolysaccharide (LPS) stimulation were analyzed by polychromatic flow cytometry. The serum TNF-α, IL-1ß, IL-6, and IL-10 levels were measured by Luminex. LPS-binding protein (LBP), intestinal fatty acid-binding protein (I-FABP), and zonulin were measured by enzyme-linked immunosorbent assay (ELISA). Results: MDD patients had a significant increase in the frequency of intermediate monocytes and a significant decrease in the frequency of classical monocytes compared to those in the healthy controls. MDD patients had a significantly increased percentage of classical monocytes that expressed IL-1ß, intermediate monocytes that expressed IL-1ß and IL6 and nonclassical monocytes that expressed IL-1ß, and decreased levels of nonclassical monocytes that expressed IL6 compared to those in the healthy controls. MDD patients had significantly increased levels of circulating TNF-α, IL-1ß, LBP, and I-FABP compared to those in the healthy controls. MDD patients with high LBP levels had a significant reduction in the number of circulating monocytes compared to that in the normal-LBP MDD patients, which can be mainly ascribed to a decrease in the number of intermediate and nonclassical monocytes. Conclusions: We have demonstrated that compared to the healthy controls, MDD patients show a marked alteration in circulating monocytes, with an expansion of the intermediate subset with increased frequency of IL-1ß and IL-6 producing cells. These patients also exhibited a systemic proinflammatory state, which was characterized by the enhanced serum TNF-α and IL-1ß levels compared to those in the healthy controls. Furthermore, MDD patients showed increased LBP and I-FABP levels compared to those in healthy controls, indicating increased bacterial translocation and gut barrier damage.

Meta-Analysis of Functional Neuroimaging and Cognitive Control Studies in Schizophrenia: Preliminary Elucidation of a Core Dysfunctional Timing Network.

Timing and other cognitive processes demanding cognitive control become interlinked when there is an increase in the level of difficulty or effort required. Both functions are interrelated and share neuroanatomical bases. A previous meta-analysis of neuroimaging studies found that people with schizophrenia had significantly lower activation, relative to normal controls, of most right hemisphere regions of the time circuit. This finding suggests that a pattern of disconnectivity of this circuit, particularly in the supplementary motor area, is a trait of this mental disease. We hypothesize that a dysfunctional temporal/cognitive control network underlies both cognitive and psychiatric symptoms of schizophrenia and that timing dysfunction is at the root of the cognitive deficits observed. The goal of our study was to look, in schizophrenia patients, for brain structures activated both by execution of cognitive tasks requiring increased effort and by performance of time perception tasks. We conducted a signed differential mapping (SDM) meta-analysis of functional neuroimaging studies in schizophrenia patients assessing the brain response to increasing levels of cognitive difficulty. Then, we performed a multimodal meta-analysis to identify common brain regions in the findings of that SDM meta-analysis and our previously-published activation likelihood estimate (ALE) meta-analysis of neuroimaging of time perception in schizophrenia patients. The current study supports the hypothesis that there exists an overlap between neural structures engaged by both timing tasks and non-temporal cognitive tasks of escalating difficulty in schizophrenia. The implication is that a deficit in timing can be considered as a trait marker of the schizophrenia cognitive profile.

A brief report of depressive symptoms and health promoting behaviors among women with infertility attending a clinical mind-body program.

Diagnosis of infertility or treatment for infertility can result in distress, including for some women, depressive symptoms. Integrative infertility treatment programs are gaining recognition and popularity, and many women may seek this kind of care. However, depressive symptoms may be a barrier to fully engaging in and benefiting from mind-body infertility programs. The aim of this retrospective, cross-sectional chart review, was to describe the baseline level of depressive symptoms and differences in baseline health promoting behaviors by level of depressive symptoms among women (n=104) presenting to a mind-body infertility program in the clinical setting. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II), and health promoting behaviors were assessed using the Health Promoting Lifestyle Profile-II (HPLP-II). The mean BDI-II score for the sample was 16.3 (± 8.5). Participants scoring in the moderate-severe range on the BDI-II had significantly lower scores on Spiritual Growth, Interpersonal Relations, Stress Management and Nutrition subscales of the HPLP-II. There were no significant differences on the Physical Activity or Health Responsibility subscales. These findings may have implications for the treatment of women with infertility, particularly those who seek an integrative approach to treatment.