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1.
Schizophr Res ; 241: 187-196, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35139458

RESUMO

Psychotic episodes occur in a substantial proportion of patients suffering from major mood disorders (both unipolar and bipolar) at some point in their lives. The nature of these episodes is less well understood than the more common, non-psychotic periods of illness and hence their management is also less sophisticated. This is a concern because the risk of suicide is particularly high in this subtype of mood disorder and comorbidity is far more common. In some cases psychotic symptoms may be signs of a comorbid illness but the relationship of psychotic mood to other forms of psychosis and in particular its interactions with schizophrenia is poorly understood. Therefore, our targeted review draws upon extant research and our combined experience to provide clinical context and a framework for the management of these disorders in real-world practice - taking into consideration both biological and psychological interventions.


Assuntos
Transtorno Bipolar , Transtorno Depressivo Maior , Transtornos Psicóticos , Transtorno Bipolar/complicações , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/terapia , Comorbidade , Transtorno Depressivo Maior/epidemiologia , Humanos , Transtornos do Humor/diagnóstico , Transtornos do Humor/etiologia , Transtornos do Humor/terapia , Transtornos Psicóticos/complicações , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/terapia
2.
J Psychiatry Neurosci ; 47(3): E176-E185, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35508328

RESUMO

BACKGROUND: Abnormalities of cortical morphology have been consistently reported in major depressive disorder (MDD), with widespread focal alterations in cortical thickness, surface area and gyrification. However, it is unclear whether these distributed focal changes disrupt the system-level architecture (topology) of brain morphology in MDD. If present, such a topological disruption might explain the mechanisms that underlie altered cortical morphology in MDD. METHODS: Seventy-six patients with first-episode MDD (33 male, 43 female) and 66 healthy controls (32 male, 34 female) underwent structural MRI scans. We calculated cortical indices, including cortical thickness, surface area and local gyrification index, using FreeSurfer. We constructed morphological covariance networks using the 3 cortical indices separately, and we analyzed the topological properties of these group-level morphological covariance networks using graph theoretical approaches. RESULTS: Topological differences between patients with first-episode MDD and healthy controls were restricted to the thickness-based network. We found a significant decrease in global efficiency but an increase in local efficiency of the left superior frontal gyrus and the right paracentral lobule in patients with first-episode MDD. When we simulated targeted lesions affecting the most highly connected nodes, the thickness-based networks in patients with first-episode MDD disintegrated more rapidly than those in healthy controls. LIMITATIONS: Our sample of patients with first-episode MDD has limited generalizability to patients with chronic and recurrent MDD. CONCLUSION: A systems-level disruption in cortical thickness (but not surface area or gyrification) occurs in patients with first-episode MDD.


Assuntos
Transtorno Depressivo Maior , Encéfalo/patologia , Córtex Cerebral/patologia , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/patologia , Feminino , Lobo Frontal/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Córtex Pré-Frontal/patologia
3.
J Psychiatry Neurosci ; 47(3): E186-E193, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35508329

RESUMO

BACKGROUND: Frontal asymmetry plays a major role in depression. However, patients with treatment-resistant depression (TRD) have widespread hypofrontality. We investigated whether patients with TRD have a characteristic frontal activation pattern in functional near-infrared spectroscopy (fNIRS) findings and how the frontal cortex responds to different levels of cognitive tasks. METHODS: We enrolled 27 right-handed patients with TRD, 27 patients without TRD and 27 healthy controls. We used multichannel fNIRS to evaluate activation of the bilateral dorsolateral prefrontal cortex (DLPFC), ventrolateral prefrontal cortex (VLPFC) and left motor area in response to 3 tasks: finger tapping, a low cognitive-load motor task; verbal fluency, a moderate cognitive-load task; and a dual task involving simultaneous finger tapping and verbal fluency, a high cognitive-load task. RESULTS: We found significant between-group differences in left DLPFC activation for all 3 tasks. The healthy controls had cortical activation in the left motor area during finger tapping and the bilateral frontal cortex during the dual task. However, patients without TRD had right VLPFC activation during finger tapping and left DLPFC activation during the dual task. Patients with TRD had bilateral DLPFC activation during finger tapping but exhibited increased bilateral VLPFC and left motor area activation during verbal fluency and increased left motor area activation during the dual task. In healthy controls and patients without TRD, we found that the right VLPFC was positively correlated with depression severity. LIMITATIONS: Our cohort included only patients with late-onset depression. CONCLUSION: We found different patterns of abnormal frontal activation between patients with and without TRD. In patients without TRD, the right prefrontal cortex (PFC) was recruited during simple motor tasks. However, in patients with TRD, the bilateral PFC was recruited during simple tasks and motor cortical resources were used compensatorily during PFC-demanding complex cognitive tasks.


Assuntos
Transtorno Depressivo Maior , Córtex Motor , Depressão , Transtorno Depressivo Maior/diagnóstico por imagem , Humanos , Córtex Motor/diagnóstico por imagem , Córtex Pré-Frontal/diagnóstico por imagem , Espectroscopia de Luz Próxima ao Infravermelho/métodos
4.
Inquiry ; 59: 469580221096278, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35532315

RESUMO

OBJECTIVE: The COVID-19 pandemic has increased psychological distress among common people and has caused health care providers, such as nurses, to experience tremendous stress. METHODS: This prospective cross-sectional study assessed the psychological impacts on nurses in a community hospital in Taiwan, including major depressive disorder (MDD), posttraumatic stress (PTS), and pessimism. According to transactional theory, coping strategies and personal factors have psychological impacts. We hypothesized that behavioral responses to COVID-19 (problem-focused coping) are more effective in reducing psychological impacts than emotional responses to COVID-19 (emotion-focused coping). Independent variables were the use of behavioral and emotional coping strategies for COVID-19 and 3 personal factors, namely sleep disturbance, physical component summary (PCS-12), and mental component summary (MCS-12) of the 12-Item Short Form Health Survey (SF-12) obtained from the Medical Outcomes Study. Dependent variables comprised 3 psychological impacts, namely MDD, PTS, and pessimism. RESULTS: We determined that behavioral coping strategies had significant negative effects on PTS and pessimism; however, emotional coping strategies had significantly positive effects on PTS and pessimism. Sleep disturbance was significantly associated with increased MDD and pessimism. PCS-12 had a significant negative effect on PTS, whereas MCS-12 was not significantly associated with any of the 3 psychological impacts. CONCLUSIONS: Nurses who adopted protective behavior against COVID-19, such as washing hands, wearing masks, avoiding touching eyes, and mouth, and avoiding personal contact, were associated with less posttraumatic stress and pessimism. Healthcare providers should consider strategies for improving preventive behaviors to help ease their worries and fears concerning COVID-19.


Assuntos
COVID-19 , Transtorno Depressivo Maior , Adaptação Psicológica , Estudos Transversais , Humanos , Pandemias , Estudos Prospectivos , Inquéritos e Questionários , Taiwan/epidemiologia
5.
Transl Psychiatry ; 12(1): 195, 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35538052

RESUMO

Adolescence represents a critical developmental period where the prevalence of major depressive disorder (MDD) increases. Aberrant emotion processing is a core feature of adolescent MDD that has been associated with functional alterations within the prefrontal-amygdala circuitry. In this study, we tested cognitive and neural mechanisms of emotional face processing in adolescents with MDD utilizing a combination of computational modeling and neuroimaging. Thirty adolescents with MDD (age: M = 16.1 SD = 1.4, 20 females) and 33 healthy controls (age: M = 16.2 SD = 1.9, 20 females) performed a dynamic face- and shape-matching task. A linear ballistic accumulator model was fit to the behavioral data to study differences in evidence accumulation. We used dynamic causal modeling (DCM) to study effective connectivity in the prefrontal-amygdala network to reveal the neural underpinnings of cognitive impairments while performing the task. Face processing efficiency was reduced in the MDD group and most pronounced for ambiguous faces with neutral emotional expressions. Critically, this reduction was related to increased deactivation of the subgenual anterior cingulate (sgACC). Connectivity analysis showed that MDD exhibited altered functional coupling in a distributed network spanning the fusiform face area-lateral prefrontal cortex-sgACC and the sgACC-amygdala pathway. Our results suggest that MDD is related to impairments of processing nuanced facial expressions. Distributed dysfunctional coupling in the face processing network might result in inefficient evidence sampling and inappropriate emotional responses contributing to depressive symptomatology. Our study provides novel insights in the characterization of brain function in adolescents with MDD that strongly emphasize the critical role of aberrant prefrontal-amygdala interactions during emotional face processing.


Assuntos
Transtorno Depressivo Maior , Reconhecimento Facial , Adolescente , Tonsila do Cerebelo , Mapeamento Encefálico , Transtorno Depressivo Maior/diagnóstico por imagem , Emoções/fisiologia , Expressão Facial , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino
6.
J Med Internet Res ; 24(5): e30907, 2022 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-35594137

RESUMO

BACKGROUND: Depression is associated with significant morbidity and human capital costs globally. Early screening for depressive symptoms and timely depressive disorder case identification and intervention may improve health outcomes and cost-effectiveness among affected individuals. China's public and academic communities have reached a consensus on the need to improve access to early screening, diagnosis, and treatment of depression. OBJECTIVE: This study aims to estimate the screening prevalence and associated factors of subthreshold depressive symptoms among Chinese residents enrolled in the cohort study using a mobile app-based integrated mental health care model and investigate the 12-month incidence rate and related factors of major depressive disorder (MDD) among those with subthreshold depressive symptoms. METHODS: Data were drawn from the Depression Cohort in China (DCC) study. A total of 4243 community residents aged 18 to 64 years living in Nanshan district, Shenzhen city, in Guangdong province, China, were encouraged to participate in the DCC study when visiting the participating primary health care centers, and 4066 (95.83%) residents who met the DCC study criteria were screened for subthreshold depressive symptoms using the Patient Health Questionnaire-9 at baseline. Of the 4066 screened residents, 3168 (77.91%) with subthreshold depressive symptoms were referred to hospitals to receive a psychiatric diagnosis of MDD within 12 months. Sleep duration, anxiety symptoms, well-being, insomnia symptoms, and resilience were also investigated. The diagnosis of MDD was provided by trained psychiatrists using the Mini-International Neuropsychiatric Interview. Univariate and multivariate logistic regression models were performed to explore the potential factors related to subthreshold depressive symptoms at baseline, and Cox proportional hazards models were performed to explore the potential factors related to incident MDD. RESULTS: Anxiety symptoms (adjusted odds ratio [AOR] 1.63, 95% CI 1.42-1.87) and insomnia symptoms (AOR 1.13, 95% CI 1.05-1.22) were associated with an increased risk of subthreshold depressive symptoms, whereas well-being (AOR 0.93, 95% CI 0.87-0.99) was negatively associated with depressive symptoms. During the follow-up period, the 12-month incidence rate of MDD among participants with subthreshold depressive symptoms was 5.97% (189/3168). After incorporating all significant variables from the univariate analyses, the multivariate Cox proportional hazards model reported that a history of comorbidities (adjusted hazard ratio [AHR] 1.49, 95% CI 1.04-2.14) and anxiety symptoms (AHR 1.13, 95% CI 1.09-1.17) were independently associated with an increased risk of incident MDD. The 5-item World Health Organization Well-Being Index was associated with a decreased risk of incident MDD (AHR 0.90, 95% CI 0.86-0.94). CONCLUSIONS: Elevated anxiety symptoms and unfavorable general well-being were significantly associated with subthreshold depressive symptoms and incident MDD among Chinese residents in Shenzhen. Early screening for subthreshold depressive symptoms and related factors may be helpful for identifying populations at high risk of incident MDD.


Assuntos
Transtorno Depressivo Maior , Aplicativos Móveis , Distúrbios do Início e da Manutenção do Sono , China/epidemiologia , Estudos de Coortes , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/terapia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/terapia , Humanos , Saúde Mental
7.
Neuroreport ; 33(9): 380-385, 2022 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-35594428

RESUMO

OBJECTIVE: There is evidence that hippocampal volume is abnormal in patients with major depressive disorder (MDD), but there have been no studies on volumetric changes in different subfields based on functional topography. This was investigated in the present study by comparing hippocampal neurofunctional subfield volumes between MDD patients and healthy control (HC) subjects. METHODS: Patients with MDD (n = 44) and HCs (n = 27) recruited at Shanghai Traditional Chinese Medicine Integrated Hospital underwent a T1-weighted anatomical MRI scan in the sagittal orientation, and the data were used to calculate hippocampal subfield volumes. Logistic regression was used to evaluate the association between the volumes and risk of MDD. A nomogram for predicting MDD risk based on volume changes in different subfields was developed, and its predictive power was evaluated by calculating the concordance (C)-index. RESULTS: Compared with HCs, MDD patients showed reduced volume in hippocampal neurofunctional subfields, specifically in left (L)1, right (R)1, and R2 (related to emotion) and L2, L3, and R4 (related to cognition and perception). The logistic regression analysis revealed that the risk of MDD was 4.59-, 5.8-, 8.33-, and 6.92-fold higher with atrophies of L1, L2, L3, and R4, respectively. A nomogram for predicting MDD risk was developed based on age; sex; and hippocampal L1, L2, L3, and R4 subfield volumes and showed good accuracy, with a C-index of 0.784. CONCLUSION: Volumetric changes in the neurofunctional subfield of the hippocampus are potential imaging markers that can predict the occurrence of MDD.


Assuntos
Transtorno Depressivo Maior , Biomarcadores , China , Transtorno Depressivo Maior/diagnóstico por imagem , Hipocampo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética/métodos , Tamanho do Órgão
8.
Sci Rep ; 12(1): 8594, 2022 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-35597802

RESUMO

Current treatments for major depressive disorder are limited to neuropharmacological approaches and are ineffective for large numbers of patients. Recently, alternative means have been explored to understand the etiology of depression. Specifically, changes in the microbiome and immune system have been observed in both clinical settings and in mouse models. As such, microbial supplements and probiotics have become a target for potential therapeutics. A current hypothesis for the mechanism of action of these supplements is via the aryl hydrocarbon receptor's (Ahr) modulation of the T helper 17 cell (Th17) and T regulatory cell axis. As inflammatory RORγt + CD4 + Th17 T cells and their primary cytokine IL-17 have been implicated in the development of stress-induced depression, the connection between stress, the Ahr, Th17s and depression remains critical to understanding mood disorders. Here, we utilize genetic knockouts to examine the role of the microbial sensor Ahr in the development of stressinduced despair behavior. We observe an Ahr-independent increase in gut-associated Th17s in stressed mice, indicating that the Ahr is not responsible for this communication. Further, we utilized a CD4-specific RAR Related Orphan Receptor C (Rorc) knockout line to disrupt the production of Th17s. Mice lacking Rorc-produced IL-17 did not show any differences in behavior before or after stress when compared to controls. Finally, we utilize an unsupervised machine learning system to examine minute differences in behavior that could not be observed by traditional behavioral assays. Our data demonstrate that neither CD4 specific Ahr nor Rorc are necessary for the development of stress-induced anxiety- or depressive-like behaviors. These data suggest that research approaches should focus on other sources or sites of IL-17 production in stress-induced depression.


Assuntos
Transtorno Depressivo Maior , Membro 3 do Grupo F da Subfamília 1 de Receptores Nucleares , Animais , Linfócitos T CD4-Positivos , Transtorno Depressivo Maior/metabolismo , Humanos , Interleucina-17/metabolismo , Camundongos , Membro 3 do Grupo F da Subfamília 1 de Receptores Nucleares/metabolismo , Receptores de Hidrocarboneto Arílico/metabolismo , Células Th17
9.
Transl Psychiatry ; 12(1): 179, 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35501309

RESUMO

Subanesthetic-dose racemic (R,S)-ketamine (ketamine) produces rapid, robust, and sustained antidepressant effects in major depressive disorder (MDD) and bipolar disorder (BD) and has also been shown to effectively treat neuropathic pain, complex regional pain syndrome, and post-traumatic stress disorder (PTSD). However, to date, its mechanism of action remains unclear. Preclinical studies found that (2 R,6 R;2 S,6 S)-hydroxynorketamine (HNK), a major circulating metabolite of ketamine, elicits antidepressant effects similar to those of ketamine. To help determine how (2 R,6 R)-HNK contributes to ketamine's mechanism of action, an exploratory, targeted, metabolomic analysis was carried out on plasma and CSF of nine healthy volunteers receiving a 40-minute ketamine infusion (0.5 mg/kg). A parallel targeted metabolomic analysis in plasma, hippocampus, and hypothalamus was carried out in mice receiving either 10 mg/kg of ketamine, 10 mg/kg of (2 R,6 R)-HNK, or saline. Ketamine and (2 R,6 R)-HNK both affected multiple pathways associated with inflammatory conditions. In addition, several changes were unique to either the healthy human volunteers and/or the mouse arm of the study, indicating that different pathways may be differentially involved in ketamine's effects in mice and humans. Mechanisms of action found to consistently underlie the effects of ketamine and/or (2 R,6 R)-HNK across both the human metabolome in plasma and CSF and the mouse arm of the study included LAT1, IDO1, NAD+, the nitric oxide (NO) signaling pathway, and sphingolipid rheostat.


Assuntos
Transtorno Depressivo Maior , Ketamina , Animais , Antidepressivos/uso terapêutico , Encéfalo/metabolismo , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/metabolismo , Humanos , Ketamina/uso terapêutico , Metabolômica , Camundongos
10.
Oxid Med Cell Longev ; 2022: 3253687, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35498133

RESUMO

Background: Oxidative stress may be increased in a number of psychiatric disorders, including major depressive disorder (MDD). MDD has been shown to be related to insulin-like growth factor-1 (IGF-1) as well as to negative life events; exploring the interaction of IGF-1 polymorphisms and negative life events on the risk of MDD is needed. The aim of this study was to analyze the single and combined effects of IGF-1 polymorphisms (rs972936 and rs978458) and negative life events with MDD among Chinese population. Methods: 420 MDD patients (according to DSM-V) and 420 age- and gender-matched control subjects were recruited in a case-control study. Negative life events were assessed using standard rating scales. IGF-1 rs972936 and rs978458 were identified by sequencing. The chi-square (χ 2) tests were performed to explore the association of negative life events and IGF-1 polymorphisms with MDD. Results: Our results found that the negative life events were associated with the risk of MDD (P < 0.001; OR = 3.28, 95% CI: 2.19-4.85). The genotypes of IGF-1 were associated with the risk of MDD (P < 0.001); carrying the IGF-1 rs972936 C allele (OR = 1.53, 95% CI: 1.26-1.85) and rs978458 T allele (OR = 1.92, 95% CI: 1.58-2.34) had a higher risk of MDD. The combined effects between IGF-1 rs978458 and negative life events were associated with the risk of MDD (P < 0.05; OR = 2.94, 95% CI: 1.23-7.03), but IGF-1 rs972936 was not associated (P > 0.05). Conclusions: Based on the oxidative stress hypothesis, we confirm that carrying IGF-1 rs972936 C allele and rs978458 T allele have a higher risk of MDD and the combined effects between IGF-1 rs978458 and negative life events were associated with the risk of MDD among Chinese population.


Assuntos
Transtorno Depressivo Maior , Fator de Crescimento Insulin-Like I/genética , Estudos de Casos e Controles , China , Transtorno Depressivo Maior/genética , Humanos , Estresse Oxidativo/genética , Polimorfismo Genético
11.
Artigo em Inglês | MEDLINE | ID: mdl-35499363

RESUMO

OBJECTIVES: Accumulating evidence suggests that hearing loss (HL) treatment may benefit depressive symptoms among older adults with Major Depressive Disorder (MDD), but the specific individual characteristics of those who stand to improve most are unknown. METHODS: N = 37 patients ≥60 years with HL and MDD received either active or sham hearing aids in this 12-week double-blind randomized controlled trial. A combined moderator approach was utilized in the analysis in order to examine multiple different pretreatment individual characteristics to determine the specific qualities that predicted the best depressive symptom response to hearing aids. Pretreatment characteristics included: Hearing Handicap Inventory for the Elderly (HHIE-S), pure tone average (PTA), speech reception threshold (SRT), Short Physical Performance Battery (SPPB), cognition (Repeatable Battery for the Assessment of Neuropsychological Status). RESULTS: The analysis revealed a combined moderator, predicting greater improvement with active versus sham hearing aids, that had a larger effect size than any individual moderator (combined effect size [ES] = 0.49 [95% CI: 0.36, 0.76]). Individuals with worse hearing-related disability (HHIE-S: individual ES = -0.16), speech recognition (SRT: individual ES = -0.14), physical performance (SPPB: individual ES = 0.41), and language functioning (individual ES = 0.19) but with relatively less severe audiometric thresholds (PTA: individual ES = 0.17) experienced greater depressive symptom improvement with active hearing aids. CONCLUSIONS: Older adults with relatively worse HL-related, physical, and cognitive functioning may stand to benefit most from hearing aids. Given the large number of older adults experiencing HL and MDD, a non-invasive and scalable means of targeting those most likely to respond to interventions would be valuable.


Assuntos
Transtorno Depressivo Maior , Auxiliares de Audição , Idoso , Cognição , Depressão , Transtorno Depressivo Maior/terapia , Humanos , Medicina de Precisão
12.
J Clin Psychopharmacol ; 42(3): 254-259, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35499958

RESUMO

PURPOSE/BACKGROUND: Subanesthetic dosing of intravenous ketamine has shown to be an effective treatment for patients with major depressive disorder. It is unknown whether sympathetic response is related to treatment outcomes. The purpose of this study is to evaluate sympathetic response to ketamine infusions as it relates to treatment outcomes. METHODS/PROCEDURES: This retrospective study examines an outpatient population diagnosed with major depressive disorder or bipolar depression treated with ketamine infusions. Patient characteristics, depressive symptoms measured with the Patient Health Questionnaire (PHQ-9), and vital signs were retrieved by chart review. Patients (n = 145) were categorized as responders (50% reduction in PHQ-9 or less than 10 on final PHQ-9) or nonresponders. Changes in vital signs were recorded during each infusion for the initiation series. FINDINGS/RESULTS: Ketamine responders (51.7%) showed a significant greater increase in systolic blood pressure response during the first infusion when compared with nonresponders. There was no difference seen in diastolic pressure, heart rate, or rate pressure product. Changes in vital signs for subsequent infusions also did not approach significance. IMPLICATIONS/CONCLUSIONS: Physiologic sensitivity to the effects of ketamine may predict treatment responsiveness. Blood pressure and heart rate did not always increase. Further work should examine possible influences on physiologic responses.


Assuntos
Transtorno Depressivo Maior , Ketamina , Pressão Sanguínea , Depressão , Transtorno Depressivo Maior/tratamento farmacológico , Humanos , Prognóstico , Estudos Retrospectivos
13.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 47(3): 289-300, 2022 Mar 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-35545321

RESUMO

OBJECTIVES: Major depressive disorder (MDD) patients with anhedonia tend to have a poor prognosis. The underlying imaging basis for anhedonia in MDD remains largely unknown. The relationship between nodal properties and anhedonia in MDD patients need to be further investigated. Herein, this study aims to explore differences of cerebral functional node characteristics in MDD patients with severe anhedonia (MDD-SA) and MDD patients with mild anhedonia (MDD-MA) before and after the antidepressant treatment. METHODS: Ninety participants with current MDD were recruited in this study. 24-Item Hamilton Depression Scale (HAMD-24) and Snaith-Hamilton Pleasure Scale (SHAPS) were used to assess the severity of depression and anhedonia at baseline and the end of 6-months treatment. The MDD patients who scored above the 25th percentile on the SHAPS were assigned to an MDD-SA group (n=19), while those who scored below the 25th percentile were assigned to an MDD-MA group (n=18). All patients in the 2 groups received antidepressant treatment. Functional magnetic resonance imaging (fMRI) images of all the patients were collected at baseline and the end of 6-months treatment. Graph theory was applied to analyze the patients' cerebral functional nodal characteristics, which were measured by efficiency (ei) and degree (ki). RESULTS: Repeated measures 2-factor ANCOVA showed significant main effects on group on the ei and ki values of left superior frontal gyrus (LSFG) (P=0.003 and P=0.008, respectively), and on the ei and ki values of left medial orbital-frontal gyrus (LMOFG) (P=0.004 and P=0.008, respectively). Compared with the MDD-MA group, the significantly higher ei and ki values of the LSFG (P=0.015 and P=0.021, respectively), and the significantly higher ei and ki values of the LMOFG (P=0.015 and P=0.037, respectively) were observed in the MDD-SA group at baseline. Meanwhile, higher SHAPS scores could result in higher ei and ki values of LSFG (P=0.019 and P=0.026, respectively), and higher ei value of LMOFG (P=0.040) at baseline; higher SHAPS scores could result in higher ei values of LSFG (P=0.049) at the end of 6-months treatment. The multiple linear regression analysis revealed that sex were negatively correlated with the ei and ki values of LSFG (r= -0.014, P=0.004; r=-1.153, P=0.001, respectively). The onset age of MDD was negatively correlated with the ki value of LSFG (r=-0.420, P=0.034) at the end of 6-months treatment. We also found that SHAPS scores at baseline were positively correlated with the HAMD-24 scores (r=0.387, P=0.022) at the end of 6-months treatment. CONCLUSIONS: There are obvious differences in nodal properties between the MDD-SA and the MDD-MA patients, such as the high ei of LSFG in the MDD-SA patients, which may be associated with the severity of anhedonia. These nodal properties could be potential biomarkers for the prognosis of MDD. The increased ei and ki values in the LSFG of MDD-SA patients may underlie a compensatory mechanism or protective mechanism. The mechanism may be an important component of the pathological mechanism of MDD-SA. The poor prognosis in the MDD-SA patients suggests that anhedonia may predict a worse prognosis in MDD patients. Sex and onset age of MDD may affect the nodal properties of LSFG at baseline and the end of 6-months treatment.


Assuntos
Transtorno Depressivo Maior , Anedonia , Antidepressivos/uso terapêutico , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética , Córtex Pré-Frontal
14.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 47(1): 109-115, 2022 Jan 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-35545370

RESUMO

N6-methyladenosine (m6A) methylation modification is one of the most common epigenetic modifications for eukaryotic mRNA. Under the catalytic regulation of relevant enzymes, m6A participates in the body's pathophysiological processes via mediating RNA transcription, splicing, translation, and decay. In the past, we mainly focused on the regulation of m6A in tumors such as hematological tumors, cervical cancer, breast cancer. In recent years, it has been found that m6A is enriched in mRNAs of neurogenesis, cell cycle, and neuron differentiation. Its regulation in the nervous system is gradually being recognized. When the level of m6A modification and the expression levels of relevant enzyme proteins are changed, it will cause neurological dysfunction and participate in the occurrence and conversion of neurological diseases. Recent studies have found that the m6A modification and its associated enzymes were involved in major depressive disorder, Parkinson's disease, Alzheimer's disease, Fragile X syndrome, amyotrophic lateral sclerosis, and traumatic brain injury, and they also play a key role in the development of neurological diseases and many other neurological diseases. This paper mainly reviewed the recent progress of m6A modification-related enzymes, focusing on the impact of m6A modification and related enzyme-mediated regulation of gene expression on the central nervous system diseases, so as to provide potential targets for the prevention of neurological diseases.


Assuntos
Transtorno Depressivo Maior , Adenosina/metabolismo , Epigênese Genética , Humanos , Metilação , RNA Mensageiro/metabolismo
15.
BMJ Open ; 12(5): e051887, 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35534066

RESUMO

PURPOSE: The Women Aware with Their Children study was created because prospective data are required to accurately guide prevention programmes for intimate partner violence (IPV) and to improve the mental health and resettlement trajectories of women from refugee backgrounds in Australia. PARTICIPANTS: 1335 women (685 consecutively enrolled from refugee backgrounds and 650 randomly selected Australian-born) recruited during pregnancy from three public antenatal clinics in Sydney and Melbourne, Australia. The mean age was 29.7 years among women from refugee backgrounds and 29.0 years among women born in the host nation. Main measures include IPV, mood, panic, post-traumatic stress disorder, disability and living difficulties. FINDINGS TO DATE: Prevalence of IPV at all three time points is significantly higher for refugee-background women. The trend data showed that reported IPV rates among Australian-born women increased from 25.8% at time 1 to 30.1% at time 3, while for refugee-background women this rate declined from 44.4% at time 1 to 42.6% at time 3. Prevalence of major depressive disorder (MDD) at all three time points is higher for refugee-background women. MDD among Australian-born women significantly declined from 14.5% at time 1 to 9.9% at time 3, while for refugee-background women it fluctuated from 25.1% at time 1 to 17.3% at time 2 and to 19.1% at time 3. FUTURE PLANS: We are currently examining trajectories of IPV and mental disorder across four time points. Time 4 occurred during the COVID-19 pandemic, enabling a unique opportunity to examine the impacts of the pandemic over time. Time 5 started in August 2021 and time 6 will begin approximately 12 months later. The children at time 5 are in the early school years, providing the capacity to examine behaviour, development and well-being of the index child.


Assuntos
COVID-19 , Transtorno Depressivo Maior , Violência por Parceiro Íntimo , Refugiados , Adulto , Austrália/epidemiologia , Criança , Estudos de Coortes , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Masculino , Saúde Mental , Pandemias , Gravidez , Estudos Prospectivos , Refugiados/psicologia
16.
Annu Rev Clin Psychol ; 18: 553-580, 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35534123

RESUMO

The theory of constructed emotion is a systems neuroscience approach to understanding the nature of emotion. It is also a general theoretical framework to guide hypothesis generation for how actions and experiences are constructed as the brain continually anticipates metabolic needs and attempts to meet those needs before they arise (termed allostasis). In this review, we introduce this framework and hypothesize that allostatic dysregulation is a trans-disorder vulnerability for mental and physical illness. We then review published findings consistent with the hypothesis that several symptoms in major depressive disorder (MDD), such as fatigue, distress, context insensitivity, reward insensitivity, and motor retardation, are associated with persistent problems in energy regulation. Our approach transforms the current understanding of MDD as resulting from enhanced emotional reactivity combined with reduced cognitive control and, in doing so, offers novel hypotheses regarding the development, progression, treatment, and prevention of MDD.


Assuntos
Alostase , Transtorno Depressivo Maior , Encéfalo , Depressão , Transtorno Depressivo Maior/terapia , Emoções , Humanos
17.
Depress Anxiety ; 39(5): 429-440, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35535436

RESUMO

IMPORTANCE: Improving treatment outcomes for smokers with major depressive disorder (MDD) can have significant public health implications. OBJECTIVE: To evaluate the safety and efficacy of smoking cessation pharmacotherapy among smokers with MDD. DESIGN: Secondary analysis of a randomized, double-blind, active- (nicotine patch) and placebo-controlled trial of 12 weeks of either varenicline or bupropion with a 12-week follow-up. PARTICIPANTS: Community volunteers 18-75 years of age; smoke 10+ cigarettes/day; with clinically stable MDD (N = 2635) or no psychiatric disorder (N = 4028), from 140 sites in 16 countries. INTERVENTION: Twelve weeks of pharmacotherapy (placebo [PLA], nicotine replacement therapy [NRT], bupropion [BUP], varenicline [VAR]) plus brief cessation counseling. MEASURE(S): Primary safety outcome: the occurrence of ≥1 treatment-emergent, moderate to severe neuropsychiatric adverse event (NPSAE). Primary efficacy outcome: biochemically confirmed continuous abstinence (CA) during the final 4 weeks of treatment (Weeks 9-12). RESULTS: A total of 6653 participants (56% female; 39% MDD) ~47 years old. Risk of NPSAEs did not differ by medication for MDD. MDD had higher risk (p < .0001) for NPSAEs than the NPC. Efficacy (6653; intent-to-treat): CA rates for MDD versus NPC respectively were 31.2% versus 38.0% VAR; 23.0% versus 26.1% BUP; 22.6% versus 26.4% NRT; and 13.4% versus 13.7% PLA but no differential treatment effect was noted within the cohorts. All active treatments differed from PLA but VAR showed the largest effect. CONCLUSIONS: Results suggest that for MDD smokers, inclusive of those with recurrent episode, varenicline plus counseling may be the best pharmacological option for the treatment of smoking given its greater efficacy effect size and similar risk of NPSAEs. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01456936. https://clinicaltrials.gov/ct2/show/NCT01456936.


Assuntos
Transtorno Depressivo Maior , Abandono do Hábito de Fumar , Bupropiona/efeitos adversos , Depressão , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Poliésteres , Fumantes , Abandono do Hábito de Fumar/psicologia , Dispositivos para o Abandono do Uso de Tabaco/efeitos adversos , Resultado do Tratamento , Vareniclina/efeitos adversos
18.
J Med Syst ; 46(6): 38, 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35536347

RESUMO

Over the last two decades, metric-based instruments have garnered popularity in mental health. Self-administered surveys, such as the Patient Health Questionnaire 9 (PHQ 9), have been leveraged to inform treatment practice of Major Depressive Disorder (MDD). The aim of this study was to measure the reliability and usability of a novel voice-based delivery system of the PHQ 9 using Amazon Alexa within a patient population. Forty-one newly admitted patients to a behavioral medicine clinic completed the PHQ 9 at two separate time points (first appointment and one-month follow up). Patients were randomly assigned to a version (voice vs paper) completing the alternate format at the next appointment. Patients additionally completed a 26-item User Experience Questionnaire (UEQ) and open-ended questionnaire at each session. Assessments between PHQ 9 total scores for the Alexa and paper version showed a high degree of reliability (α = .86). Quantitative UEQ results showed significantly higher overall positive attitudes towards the Alexa format with higher subscale scores on attractiveness, stimulation, and novelty. Further qualitative responses supported these findings with 85.7% of participants indicating a willingness to use the device at home. With the benefit of user instruction in a clinical environment, the novel Alexa delivery system was shown to be consistent with the paper version giving evidence of reliability between the two formats. User experience assessments further showed a preference for the novel version over the traditional format. It is our hope that future studies may examine the efficacy of the Alexa format in improving the at-home clinical treatment of depression.


Assuntos
Transtorno Depressivo Maior , Questionário de Saúde do Paciente , Transtorno Depressivo Maior/terapia , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
20.
J Psychiatr Pract ; 28(3): 265-269, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35511105

RESUMO

We present the case of a woman in her 40s with a history of hypothyroidism, a differential diagnosis of major depressive disorder with psychotic features versus bipolar I disorder, catatonia, and anorexia nervosa. The patient was admitted to the hospital for poor oral intake, mutism, and social withdrawal. Administration of lorazepam successfully treated these presenting symptoms. However, on subsequent days, she was found to be reading the Bible almost constantly during waking hours, at the expense of engaging in treatment or interacting with others. The patient's history and presentation supported the idea that her hyper-religiosity stemmed not from bipolar disorder or psychosis, as previously thought, but rather from a subtype of obsessive-compulsive disorder referred to as scrupulosity. This report summarizes the characteristics of scrupulosity and discusses this potentially deceptive mimic of more commonly seen conditions.


Assuntos
Catatonia , Transtorno Depressivo Maior , Transtorno Obsessivo-Compulsivo , Catatonia/diagnóstico , Catatonia/tratamento farmacológico , Catatonia/etiologia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/tratamento farmacológico , Feminino , Humanos , Lorazepam/uso terapêutico , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/terapia
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