RESUMO
OBJECTIVE: To compare psychometric and molecular-genetic characteristics of depression caused by ischemic heart disease (IHD) and depression in patients with IHD caused by other psychogenic factors. MATERIAL AND METHODS: One hundred and thirty-five patients with depression comorbid to ischemic heart disease (IHD) were examined. Depression was associated with IHD in 71 patients (group 1). In 64 patients, depression was caused by other psychogenic factors (group 2). The HAMD-21 scale was used to measure depressive symptoms. RESULTS AND CONCLUSION: The comparative analysis of the core symptoms of depression demonstrated that group 1 had a peculiar psychometric profile with marked apathy, which was not accompanied by marked hypothymia, guilt feelings or anxiety, compared to group 2. The molecular-genetic correlate of this profile was found. It included a combination of an allele S (5-HTTLPR) of the serotonin transporter gene, an allele G (A-1438G) of the serotonin receptor type 2A gene and the genotype ValVal (Val66Met) of the brain-derived neurotrophic factor gene.
Assuntos
Fator Neurotrófico Derivado do Encéfalo/genética , DNA/genética , Depressão/genética , Estudos de Associação Genética/métodos , Isquemia Miocárdica/genética , Polimorfismo Genético , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Comorbidade , Depressão/epidemiologia , Depressão/metabolismo , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/epidemiologia , Isquemia Miocárdica/metabolismo , Psicometria/métodos , Federação Russa/epidemiologia , Proteínas da Membrana Plasmática de Transporte de Serotonina/metabolismoRESUMO
In a framework of search for early predictors of depression in patients with ischemic heart disease (IHD) we studied effect of molecular-genetic factors (polymorphism of brain-derived neirotrophic factor--BDNF), personality traits (anxiety, neuroticism), IHD severity, and psychosocial stressors on manifestations of depression in men with verified diagnosis of IHD. Severity of depression was assessed by Hamilton Depression Rating Scale 21-item (HAMD 21), anxiety and neuroticism were evaluated by the Spielberger State-Trait Anxiety Inventory and "Big Five" questionnaire, respectively. It wa shown that personal anxiety and ValVal genotype of BDNF gene appeared to be predictors of moderate and severe depression.
Assuntos
Ansiedade/genética , Fator Neurotrófico Derivado do Encéfalo/genética , DNA/genética , Depressão/genética , Isquemia Miocárdica/complicações , Polimorfismo Genético , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/complicações , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Depressão/etiologia , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/psicologia , Reação em Cadeia da Polimerase , Prognóstico , Índice de Gravidade de DoençaRESUMO
In a framework of search for early predictors of depression in patients with ischemic heart disease (IHD) we studied effect of molecular- genetic factors (polymorphism of brain-derived neirotrophic factor - BDNF), personality traits (anxiety, neuroticism), IHD severity, and psychosocial stressors on manifestations of depression in men with verified diagnosis of IHD. Severity of depression was assessed by Hamilton Depression Rating Scale 21-Item (HAMD 21), anxiety and neuroticism were evaluated by the Spielberger State-Trait Anxiety Inventory and "Big Five" questionnaire, respectively. It was shown that personal anxiety and ValVal genotype of BDNF gene appeared to be predictors of moderate and severe depression.
RESUMO
Associations between 5-HTR2A -1438A/G and 5-HTR2C Cys23Ser polymorphisms and depression and its severity were studied in CHD patients with consideration for the trigger factors, pathogenetic characteristics of CHD, and personal anxiety. The study was carried out in 169 men aged 31-84 (59.0 ± 8.8) years with verified CHD. Depression was more severe (Hamilton score) if it was caused by manifestation or exacerbation of CHD (nosogenic factor) and in the presence of the painful syndrome caused by the cardiac disease, high personal anxiety, and presence of allele G polymorphism - 1438A/G in the genotype. The risk of medium-severe and severe depression in allele G carriers was 2.4-fold higher than in AA genotype carriers. The nosogenic factor modulated the association between allele G and severity of depression symptoms. The risk of medium-severe and severe depression was almost 4-fold higher in carriers of this allele in the presence of this factor.
Assuntos
Doença das Coronárias/genética , Depressão/genética , Receptor 5-HT2A de Serotonina/genética , Receptor 5-HT2C de Serotonina/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Substituição de Aminoácidos , Estudos de Casos e Controles , Doença das Coronárias/psicologia , Frequência do Gene , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético , Risco , Adulto JovemRESUMO
Depression is commonly present in patients with coronary heart disease (CHD). Identification of early predictors of depression in CHD patients is an important direction of current research in the field of psychosomatic medicine. Serotonin transporter gene polymorphism (5-HTTLPR) was earlier reported to contribute to the development of depression comorbid to CHD. The present study aimed at investigating the role of the 5-HTTLPR polymorphism, stress factors and personality traits in the prediction of depressive symptoms in patients with CHD. The study included 169 male patients, aged from 31 to 84 years, mean age 59±8.8 years. Depression was diagnosed in 135 (79.9%) patients; in 71 (42%) patients it was related to the presence of CHD (nosogenic factor). Severity of depressive symptoms as defined by HAM-D-21 was associated with the interaction between the 5-HTTLPR polymorphism, nosogenic factor and trait anxiety. Risk of depression was 7.0 times higher in carriers of an S allele in the presence of the nosogenic factor. In other combinations of a 5-HTTLPR variant with the presence or absence of the nosogenic factor, trait anxiety contributed significantly to the variance of depressive symptoms. Patients with higher scores on the Spilberger STAI had 5 and 7 times higher risk of moderate and marked depression compared to those with moderate and low anxiety scores. The approach suggested in the study may be useful for the prediction of depression and its severity in patients with CHD.
