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Minhas S, Chandan JS, Knibb R, Diwakar L, Adderley N. Association between atopic disorders and mental ill health: a UK-based retrospective cohort study. BMJ Open 2025; 15:e089181. [PMID: 40449946 DOI: 10.1136/bmjopen-2024-089181] [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] [Indexed: 06/03/2025] Open
Abstract
OBJECTIVE To examine the mental ill health burden associated with allergic and atopic disorders, in a UK primary care cohort. DESIGN Population-based retrospective open cohort study. SETTING United Kingdom. PARTICIPANTS 2 491 086 individuals with primary-care recorded atopic disorder (food allergy, drug allergy, anaphylaxis, urticaria, allergic rhino-conjunctivitis) diagnosis were matched by sex, age (± 2 years), and socio-economic deprivation (Townsend quintile score) at index to 3 120 719 unexposed individuals. The mean age of exposed patients at cohort entry was 39.42 years (SD (SD) 23.65) compared with 35.81 years (SD 22.17) for unexposed patients. MAIN OUTCOME MEASURES The primary outcome was a composite of mental ill health (severe mental illness, anxiety, depression, eating disorders, obsessive-compulsive disorder (OCD), and self-harm), identified using Read codes. Cox regression was used to estimate adjusted hazard ratios with 95% confidence intervals for the composite mental ill health outcome and each of the individual mental health disorders. Covariates adjusted for were age, sex, alcohol use, smoking status, body mass index (BMI), Townsend deprivation quintile score, asthma exposure, and eczema exposure at baseline. RESULTS Between first January 1995 to 31st January 2022, a total of 2 491 086 eligible individuals were identified with a primary care recorded diagnosis of atopic disease and were matched to 3 120 719 unexposed individuals. 229 124 exposed individuals developed a mental ill health outcome during the study period (incidence ratio (IR) 144.13 per 10 000 person-years) compared with 203 450 in the unexposed group (IR 117.82 per 10 000 person-years). This translated to an adjusted hazard ratio (aHR) of 1.16 (95% CI 1.15 to 1.17). Notably, the risk of anxiety was greatest, aHR 1.22 (95% CI 1.21 to 1.23). Our findings were robust to a sensitivity analysis, where individuals were also matched for asthma and eczema. CONCLUSION There is an increased risk of mental ill health disorders among patients with diagnosis of an allergic and atopic disorders. There is a need to consider dual delivery of allergy and psychology services to optimise mental well-being among this cohort.
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Affiliation(s)
- Sonica Minhas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK
| | | | - Lavanya Diwakar
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Nicola Adderley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK
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Ju Y, Liu Y, Tan L, Su L. Drug-related suicidal ideation in the K-12 population: a real-world pharmacovigilance study of the FDA adverse event reporting system (FAERS) database. J Psychiatr Res 2025; 188:1-9. [PMID: 40413828 DOI: 10.1016/j.jpsychires.2025.05.029] [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: 08/12/2024] [Revised: 03/27/2025] [Accepted: 05/14/2025] [Indexed: 05/27/2025]
Abstract
OBJECTIVE The K-12 population refers to individuals, primarily aged 6-17, from kindergarten through 12th grade. Drug-related suicidal ideation (SI) in the K-12 population is a major concern. This study aims to identify medications linked to increased SI risk in the K-12 population using the FDA Adverse Event Reporting System (FAERS) database. METHODS We extracted cases of SI in individuals aged 6-17 years where medications were the primary suspect (PS) from the FAERS database, spanning from the first quarter of 2004 to the third quarter of 2023. We conducted descriptive analysis, disproportionality analysis, and subgroup analysis. RESULTS Our analysis included 4,779 valid cases; 52.75 % were male and 45.66 % were female. The predominant age group was 15-17 years, accounting for 43.92 % of cases. The peak year for case reports was 2019. Montelukast was the most common drug. The four most common indications included attention deficit hyperactivity disorder, depression, acne, and asthma. Disproportionality analysis highlighted 21 drugs as potentially associated with increased SI risk, with esketamine displaying the highest signal (Reporting Odds Ratio, ROR = 103.49). Subgroup analysis identified eleven drugs with elevated risk signals in both genders. Montelukast presented the highest signal in males (ROR = 12.64), and esketamine in females (ROR = 129.50). Cumulatively, the incidence of SI within 90 and 360 days was 51.6 % and 76.9 % in males, and 58.8 % and 85.3 % in females, respectively. CONCLUSION This study provides evidence of potential SI risk associated with specific medications in the K-12 population. Further research is necessary to confirm these findings.
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Affiliation(s)
- Yaxin Ju
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China
| | - Yuan Liu
- Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, No. 288, Tianwen Avenue, Chayuan, Nan'an District, Chongqing, China
| | - Li Tan
- Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, No. 288, Tianwen Avenue, Chayuan, Nan'an District, Chongqing, China
| | - Li Su
- Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, No. 288, Tianwen Avenue, Chayuan, Nan'an District, Chongqing, China.
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Chen VCH, Wang TN, Kuo CJ, Yang YH, Lee CP, Stewart R, Wu SI. Associations of asthma and psychiatric comorbidities on suicide mortality among community adolescents: A 20-year cohort study. Psychiatry Res 2024; 340:116087. [PMID: 39182318 DOI: 10.1016/j.psychres.2024.116087] [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: 03/13/2024] [Revised: 07/01/2024] [Accepted: 07/14/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND The role of psychiatric comorbidity as a confounder between asthma and subsequent suicide mortality in adolescents remained unclarified. METHODS This study used a 20-year community-based cohort in Taiwan. Adolescents aged 11 to 16 from 123 schools were classified into three subgroups: current asthma (symptoms present in the past year), previous asthma (history of asthma but no symptoms in the past year), and no asthma. The mortality and medical care utilizations until the end of follow-up in 2015 were obtained. Cox proportional hazard and competing risk models were performed. Different adjustment models that included covariates of demographic status, allergy, cigarette smoking, psychiatric diagnoses, alcohol or substance misuse, and attention deficit and hyperactivity disorders were compared. RESULTS During the follow-up, 285 out of 153,526 participants died from suicide. The crude hazard ratio for suicide was 1.95 (95 % CI=1.46∼2.60) in the current asthma subgroup and 2.01 (1.36∼2.97) in the previous asthma subgroup. The adjusted hazard ratios (aHR) attenuated to 1.67 (1.25∼2.24) and 1.72 (1.16∼2.54) respectively after further adjustment for all mental disorders, ADHD, substance, and alcohol use disorders. CONCLUSIONS Our adjustment analyses stratified by different models highlight evidence of asthma as an independent risk factor that predicts suicide among adolescents. Depression and mental disorders were potential confounders and identifications of asthma and psychiatric disorders might help decrease suicide risk.
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Affiliation(s)
- Vincent Chin-Hung Chen
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Tsu-Nai Wang
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Yao-Hsu Yang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Center of Excellence for Chang-Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chuan-Pin Lee
- Center of Excellence for Chang-Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Shu-I Wu
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Section of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan.
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Greydanus DE, Nazeer A, Qayyum Z, Patel DR, Rausch R, Hoang LN, Miller C, Chahin S, Apple RW, Saha G, Prasad Rao G, Javed A. Pediatric suicide: Review of a preventable tragedy. Dis Mon 2024; 70:101725. [PMID: 38480023 DOI: 10.1016/j.disamonth.2024.101725] [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] [Indexed: 09/07/2024]
Abstract
Concepts of suicide are explored in this issue with a focus on suicide in children and adolescents. The epidemiology of pediatric suicide in the United States is reviewed; also, risk and protective factors, as well as prevention strategies, are discussed. Suicide in the pediatric athlete and the potential protective effect of exercise are examined. In addition, this analysis addresses the beneficial role of psychological management as well as current research on pharmacologic treatment and brain stimulation procedures as part of comprehensive pediatric suicide prevention. Though death by suicide in pediatric persons has been and remains a tragic phenomenon, there is much that clinicians, other healthcare professionals, and society itself can accomplish in the prevention of pediatric suicide as well as the management of suicidality in our children and adolescents.
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Affiliation(s)
- Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.
| | - Ahsan Nazeer
- Division of Child and Adolescent Psychiatry, Sidra Medicine/Weill Cornell Medicine, Doha, Qatar
| | - Zheala Qayyum
- Harvard Medical School, Boston, Massachusetts, United States
| | - Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Rebecca Rausch
- Division of Pediatric Psychology, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Linh-Nhu Hoang
- Western Michigan University, Kalamazoo, MI, United States
| | - Caroline Miller
- Fielding Graduate University, Santa Barbara, CA, United States
| | - Summer Chahin
- Mott Children's Hospital, University of Michigan, Ann Arbor, MI, United States
| | - Roger W Apple
- Division of Pediatric Psychology, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Gautam Saha
- Immediate Past President of the SAARC (South Asian Association for Regional Cooperation) Psychiatric Federation (SPF), India
| | - G Prasad Rao
- President, Asian Federation of Psychiatric Association (AFPA), India
| | - Afzal Javed
- Chairman Pakistan Psychiatric Research Centre, Immediate Past President of the World Psychiatric Association (WPA), Pakistan
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Jin T, Seo J, Ye S, Lee S, Park EY, Oh JK, Han C, Kim B. Suicide mortality following the implementation of tobacco packaging and pricing policies in Korea: an interrupted time-series analysis. BMC Med 2024; 22:180. [PMID: 38679738 PMCID: PMC11057188 DOI: 10.1186/s12916-024-03372-5] [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: 08/31/2023] [Accepted: 03/26/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND To prevent tobacco use in Korea, the national quitline number was added to tobacco packages in December 2012, tobacco prices were raised by 80% in January 2015, and graphic health warning labels were placed on tobacco packages in December 2016. This study evaluated the association of these tobacco packaging and pricing policies with suicide mortality in Korea. METHODS Monthly mortality from suicide was obtained from Cause-of-Death Statistics in Korea from December 2007 to December 2019. Interrupted time-series analysis was performed using segmented Poisson regression models. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated adjusted for suicide prevention strategies. RESULTS Suicide mortality was 20 per 1,000,000 in December 2007 and showed a downward trend over the study period. After the implementation of tobacco packaging and pricing policies, suicide mortality immediately declined by - 0.09 percent points (95% CI = - 0.19 to 0.01; P > 0.05) for the national quitline number, - 0.22 percent points (95% CI = - 0.35 to - 0.09; P < 0.01) for tobacco prices, and - 0.30 percent points (95% CI = - 0.49 to - 0.11; P < 0.01) for graphic health warning labels. The corresponding RRs for these post-implementation changes compared with the pre-implementation level were 0.91 (95% CI = 0.83 to 1.00), 0.80 (95% CI = 0.70 to 0.91), and 0.74 (95% CI = 0.61 to 0.90), respectively. Significant associations between tobacco control policies and suicide mortality were observed even when stratified by sex and region. CONCLUSIONS The findings of this study provide new evidence for an association between tobacco control policies and deaths by suicide. An array of effective tobacco control policies should be considered for prevention programs targeting suicide.
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Affiliation(s)
- Taiyue Jin
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang, Gyeonggi, 10408, South Korea
| | - Juhee Seo
- Vital Statistics Division, Statistics Korea, Daejeon, South Korea
| | - Shinhee Ye
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, South Korea
| | - Seulbi Lee
- Department of Big Data Strategy, National Health Insurance Service, Wonju, South Korea
| | - Eun Young Park
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Jin-Kyoung Oh
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang, Gyeonggi, 10408, South Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Changwoo Han
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Byungmi Kim
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang, Gyeonggi, 10408, South Korea.
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea.
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Lo CWH, Pathadka S, Qin SX, Fung LWY, Yan VKC, Yiu HHE, Bloom CI, Wong ICK, Chan EWY. Neuropsychiatric events associated with montelukast in patients with asthma: a systematic review. Eur Respir Rev 2023; 32:230079. [PMID: 37758273 PMCID: PMC10523155 DOI: 10.1183/16000617.0079-2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/13/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND The United States Food and Drug Administration issued a black box warning on the mental health adverse effects of montelukast in 2020. Age-related effects on the risk of developing specific neuropsychiatric events in montelukast users remain largely unknown. OBJECTIVE To describe the risk of neuropsychiatric events associated with montelukast in adults and children with asthma. METHODS A systematic search of all studies investigating neuropsychiatric events in montelukast users was performed in PubMed, the Cochrane Library and Embase from inception to 7 September 2022. Animal studies and conference abstracts were excluded. RESULTS 59 studies (21 pharmacovigilance studies, four reviews from 172 randomised controlled trials, 20 observational studies, 10 case reports and four case series) evaluating neuropsychiatric events in patients with asthma on montelukast were reviewed. No significant association was shown between montelukast and suicide-related events in six of the observational studies. No association was found for depression as defined by the International Classification of Diseases 10th revision codes in three observational studies and a review of randomised clinical trials. However, findings from four studies using antidepressant prescriptions as the outcome identified significant associations. Consistent with nine pharmacovigilance studies, two large-scale observational studies revealed possible associations of montelukast with anxiety and sleeping disorders in adult patients with asthma, respectively. However, the results were not replicated in two observational studies on children. CONCLUSION Montelukast is not associated with suicide- and depression-related events in asthma patients. Older adults may be particularly susceptible to anxiety and sleeping disorders.
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Affiliation(s)
- Chris Wai Hang Lo
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Swathi Pathadka
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
- LCCI - Value, Evidence, Outcomes Division, Eli Lilly Services India Private Limited, Bengaluru, India
| | - Simon Xiwen Qin
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong SAR, China
| | - Lydia W Y Fung
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong SAR, China
| | - Vincent Ka Chun Yan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
| | - Hei Hang Edmund Yiu
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
| | - Chloe I Bloom
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Ian Chi Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong SAR, China
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
| | - Esther Wai Yin Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong SAR, China
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Underner M, Peiffer G, Perriot J, De Chazeron I, Jaafari N. [Asthma and suicidal behavior in adolescents: a literature review]. Rev Mal Respir 2022; 39:344-366. [PMID: 35459587 DOI: 10.1016/j.rmr.2021.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/21/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Adolescence is a difficult time in life and asthma has major psychological consequences for adolescents. OBJECTIVES This systematic literature review focused on the association between asthma and suicidal behaviors (suicidal ideations [SI], suicide plans [SP] and suicide attempts [SA]) among adolescents in the general population. METHOD Research on Medline for the 1980-2021 period. Objectives This systematic literature review focused on the association between asthma and suicidal behaviors (suicidal ideations [SI], suicide plans [SP] and suicide attempts [SA]) among adolescents in the general population. RESULTS An overwhelming majority of the studies taken into consideration demonstrated a significant positive association between asthma and suicidal behaviors. Among the 10 studies assessing SI (with or without SP), 9 of them found a significant positive association between asthma and SI. Eight studies assessed SA; five cross-sectional studies and one prospective study demonstrated a significant positive association between asthma and SA. Only one case-control study did not find a significant positive association between asthma and SA after hospitalization for asthma. The two cross-sectional studies assessing suicidal risk taken as a whole (SI, SP and SA) demonstrated a significant positive association between asthma and at least one suicidal behavior. (OR=1.71; P<0.001). However, several studies did not include depression as an adjustment factor. CONCLUSION It is important that healthcare professionals assess suicide risk in adolescent suffering from asthma, the objective being to avoid SA or death from SA.
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Affiliation(s)
- M Underner
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France.
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - J Perriot
- Dispensaire Émile-Roux, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - I De Chazeron
- Service de psychiatrie-addictologie, CMP-B CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - N Jaafari
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France
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Anxiety-like behavior induced by allergen is associated with decreased irregularity of breathing pattern in rats. Respir Physiol Neurobiol 2022; 298:103847. [DOI: 10.1016/j.resp.2022.103847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/18/2022]
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Jin L, Fan K, Tan S, Liu S, Wang Y, Yu S. Analysis of the characteristics of outpatient and emergency diseases in the department of otolaryngology during the "COVID-19" pandemic. Sci Prog 2021; 104:368504211036319. [PMID: 34323155 PMCID: PMC10358545 DOI: 10.1177/00368504211036319] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The pandemic of "Corona Virus Disease 2019" (COVID-19) has changed the lives of people. There have been changes in common outpatient and emergency cases in otolaryngology, so an analysis of data pertaining to this was completed. This study is to evaluate the impact of viral infection disease in otolaryngological common disease. This study uses the data of common diseases in the outpatient and emergency department during the "COVID-19" pandemic (from February to April 2020) and the same period in the past 3 years from the Department of Otolaryngology. During the "COVID-19" period compared with the same period last year, the ranking of cases by diseases has changed. Diseases such as chronic pharyngitis, allergic rhinitis, sudden deafness, and tinnitus increased, meanwhile acute pharyngitis and acute laryngopharyngitis decreased (p < 0.05). The viral infection has impacted the mental behaviors of people, therefore mental-related disease cases of the department of Otolaryngology have increased indirectly. This study provides real data to illustrate mental-related diseases. It also provides experience and shows the importance of keeping and maintaining mental health.
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Affiliation(s)
| | | | - Shiwang Tan
- Department of Otolaryngology, Head and Neck Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shuangxi Liu
- Department of Otolaryngology, Head and Neck Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yang Wang
- Department of Otolaryngology, Head and Neck Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shaoqing Yu
- Department of Otolaryngology, Head and Neck Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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Tel BC, Telli G, Onder S, Nemutlu E, Bozkurt TE. Investigation of the relationship between chronic montelukast treatment, asthma and depression-like behavior in mice. Exp Ther Med 2020; 21:27. [PMID: 33262813 PMCID: PMC7690246 DOI: 10.3892/etm.2020.9459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/26/2020] [Indexed: 12/13/2022] Open
Abstract
In 2008, the Food and Drug Administration of the US issued a warning about the neuropsychiatric side effects of montelukast. Previous clinical studies on montelukast have reported conflicting results and, to the best of our knowledge, no experimental studies concerning these side effects had been conducted. In the current study, the effect of montelukast on depression-like behavior in an ovalbumin (OVA)-induced mouse model was investigated. A total of 3 OVA challenges were applied at 2 week intervals for the persistence of asthma. Depression-like behavior was assessed using forced swim tests following each challenge and locomotor activities were evaluated using open field tests. At the end of the current study, plasma montelukast concentrations were measured and the development of asthma and effect of montelukast treatment were histopathologically examined. Inflammation scores that were increased in the OVA mice following all challenges were indicated to be reduced by montelukast treatment. The immobility time of mice increased beginning with the first challenge and this was also reduced by montelukast treatment. Montelukast administration to the control mice did not alter immobility times. Moreover, motor activity of the OVA and montelukast-treated mice were not altered. The results indicated there was no association between chronic montelukast treatment and depression. Furthermore, the chronic administration of montelukast to non-asthmatic mice did not increase immobility. However, depressive behavior increased at all time points in the OVA mice. These results indicated that chronic montelukast treatment is not associated with depression-like behavior and confirmed the association between asthma and depression. Further studies are required to provide an improved understanding of the neuropsychiatric side effects of montelukast.
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Affiliation(s)
- Banu Cahide Tel
- Department of Pharmacology, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
| | - Gokcen Telli
- Department of Pharmacology, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
| | - Sevgen Onder
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Sihhiye 06100, Turkey
| | - Emirhan Nemutlu
- Department of Analytical Chemistry, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
| | - Turgut Emrah Bozkurt
- Department of Pharmacology, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
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Sex-dependent grades of haematopoietic modulation in patients with major depressive episodes are associated with suicide attempts. Eur Neuropsychopharmacol 2020; 40:17-30. [PMID: 32600963 DOI: 10.1016/j.euroneuro.2020.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/08/2020] [Accepted: 06/09/2020] [Indexed: 01/10/2023]
Abstract
Suicide is the leading cause of non-natural death worldwide, and major depressive disorder (MDD) is the mood disorder with the highest prevalence among individuals with suicidal behaviour (SB). The role of inflammation and immunomodulation in mood disorders has raised interest in recent years, as inflammation biomarkers have been reported to be increased in mood disorder patients, suggesting a role of inflammation in their pathogenesis. The influence of inflammation on the haematopoietic production is well known; however, a comprehensive study of the haematopoietic production in patients with major depressive episodes (MDE) is lacking. We examined global haematopoietic parameters from complete blood counts (CBC) of patients with MDE, in search of prognostic patterns. MDE patients presented differences in several CBC parameters, differences that were clearly pronounced and/or significant in concurrence with suicide attempts (SA). Red and white blood cell lineage parameters were affected, suggesting general haematopoietic modulation or imbalance. We observed distinct haematological parameter changes in women versus men, with men presenting milder alterations than women. Interestingly, we found that the List of Threatening Experiences (LTE) score, but not the Childhood Trauma Questionnaire (CTQ), was associated with the haematopoietic alterations observed exclusively in women and, more importantly, served as a parameter to stratify female MDE patients based on concurrence or non-concurrence with SA. In conclusion, grades of haematopoietic modulation in MDE patients are associated with absence or presence of SA. Haematopoietic manifestations differ between men and women and, in the latter, are markedly influenced by late, and not early, traumatic events.
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Kim JY, Han YJ, Lee JS, Lee JH, Jo SH, Kim SH. Evaluation of a possible association between allergic rhinitis and depression, suicidal ideation, and suicide attempts among adolescents based on a nationwide cross-sectional study. Int J Pediatr Otorhinolaryngol 2020; 134:110070. [PMID: 32387708 DOI: 10.1016/j.ijporl.2020.110070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We assessed associated factors for depression and suicidality among adolescents with allergic rhinitis (AR) by analyzing data from annual Korea Youth Risk Behavior Web-based Surveys (KYRBSs) completed from 2007 to 2017. METHODS Data from the KYRBS were obtained from a stratified, multistage, clustered sample. Using self-reported questionnaires, students provided yes-or-no answers to questions addressing their doctor-diagnosed AR and self-experienced depression, suicidal ideation and suicide attempts. Associated factors for depression and suicidality were identified by logistic regression models after controlling for potential confounding factors. A total of 818,684 adolescents were targeted, and 788,411 adolescents completed the survey. RESULTS An AR diagnosis was reported in 30.8% of respondents. Among respondents with AR, 34.5%, 18.4%, and 4.2% reported depression, suicidal ideation, and suicide attempts, respectively. Adolescents with AR were significantly more likely to have negative mental health status, including suicidality than adolescents without AR. After multiple logistic regression analyses, perception of stress was most strongly associated with depression and suicidal ideation (adjusted odds ratio: 5.16 [95% confidence interval; 5.04-5.28], 4.81 [4.65-4.98], respectively). For suicide attempts, subjective unhappiness was most strongly associated (3.63 [3.47-3.79]) among adolescents with AR. Presence of AR itself was also associated with depression and suicidality (1.10 [1.08-1.11], 1.08 [1.06-1.10], 1.05 [1.01-1.08], respectively). CONCLUSION Adolescents with AR had significantly greater prevalence of depression and suicidality. Multidisciplinary team approaches, including psychological support, may be needed to prevent suicide among adolescents with AR, especially those with identifiable risk factors.
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Affiliation(s)
- Joo Young Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Young Joo Han
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Jun Hwa Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Seon Hui Jo
- Department of Biostatistics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Sung Hoon Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
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Postolache TT, Akram F, Lee EE, Lowry CA, Stiller JW, Brenner LA, Streeten EA, Turecki G, Dwivedi Y. Increased brain vitamin D receptor expression and decreased expression of cathelicidin antimicrobial peptide in individuals who died by suicide. J Psychiatr Res 2020; 125:75-84. [PMID: 32213352 DOI: 10.1016/j.jpsychires.2020.02.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/01/2020] [Accepted: 02/24/2020] [Indexed: 01/22/2023]
Abstract
Vitamin D deficiency is associated with immune dysregulation, increased vulnerability to infections, depression, and suicidal behavior. One mediator of vitamin D-dependent immune regulation and antimicrobial defense is the cathelicidin antimicrobial peptide (LL-37), encoded by the cathelicidin-related antimicrobial peptide (CRAMP) gene. We compared the mRNA expression of the CRAMP gene, the vitamin D receptor (VDR) gene, as well as the CYP27B1 and CYP24A1 genes (involved in vitamin D metabolism) in the dorsolateral prefrontal cortex (dlPFC) and anterior cingulate cortex (ACC) between depressed individuals who died by suicide (n = 15) and matched (age, gender, and post-mortem interval) non-psychiatric controls (n = 15). Gene expression was measured through qRT-PCR with TaqMan® primers and probes, with GAPDH and β-actin genes as endogenous controls. Statistical analyses included t-tests and Pearson correlations. CRAMP mRNA expression was downregulated and VDR mRNA expression was upregulated in both dlPFC and ACC in suicides relative to controls, with no significant differences in expression of CYP24A1 and CYP27B1. To our knowledge, this is the first study on brain cathelicidin expression in the human brain in relationship to suicide. Increased VDR and decreased CRAMP expression are consistent with previously reported associations between vitamin D deficiency, immune dysregulation, and suicidal behavior, and should lead to future studies uncovering novel interactive targets for suicide prevention.
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Affiliation(s)
- Teodor T Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA; Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, USA; Veterans Health Administration, Capitol MIRECC, Baltimore VA Medical Center, Baltimore MD, USA.
| | - Faisal Akram
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA; Saint Elizabeths Hospital, DC Department of Behavioral Health, Washington, DC, USA
| | - Ellen E Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Christopher A Lowry
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, USA; Department of Integrative Physiology, Center for Neuroscience, And Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, USA; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John W Stiller
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA; Saint Elizabeths Hospital, DC Department of Behavioral Health, Washington, DC, USA; Maryland State Athletic Commission, Baltimore, MD, USA
| | - Lisa A Brenner
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, USA; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elizabeth A Streeten
- Program for Personalized and Genomic Medicine, Department of Medicine, Endocrinology, Diabetes & Metabolism, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
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14
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Velasco Á, Rodríguez-Revuelta J, Olié E, Abad I, Fernández-Peláez A, Cazals A, Guillaume S, de la Fuente-Tomás L, Jiménez-Treviño L, Gutiérrez L, García-Portilla P, Bobes J, Courtet P, Sáiz PA. Neutrophil-to-lymphocyte ratio: A potential new peripheral biomarker of suicidal behavior. Eur Psychiatry 2020; 63:e14. [PMID: 32093807 PMCID: PMC7315873 DOI: 10.1192/j.eurpsy.2019.20] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/28/2019] [Accepted: 12/15/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as important peripheral inflammatory biomarkers. Recent data suggest a possible role of the immune system in the pathophysiology of suicidal behavior (SB). The aim of this study is to evaluate the association among NLR, MLR, and PLR and SB in patients with major depressive disorder (MDD), and to test its validity as a biomarker for suicidality. METHODS We evaluated 538 patients with MDD (mean age [standard deviation] = 43.87 [14.36] years; females: 68.8%). A logistic regression model was estimated to determine the independent factors associated with suicide risk in patients with and without a history of suicide attempt (SA). RESULTS Three hundred ninety-three patients (74.7%) had a personal history of SA. Patients with a previous SA were more frequently female (71.9% vs. 59.6%; p = 0.007), significantly younger (41.20 vs. 51.77 years; p < 0.001), had lower depression severity at enrolment (15.58 vs. 18.42; p < 0.000), and significantly higher mean NLR and PLR ratios (2.27 vs. 1.68, p = 0.001; 127.90 vs. 109.97, p = 0.007, respectively). In the final logistic regression model, after controlling for age, sex, and depression severity, NLR was significantly associated with SB (β = 0.489, p = 0.000; odds ratio [95% confidence intervals] = 1.631 [1.266-2.102]). We propose a cut-off value of NLR = 1.30 (sensitivity = 75% and specificity = 35%). CONCLUSIONS Our data suggest that NLR may be a valuable, reproducible, easily accessible, and cost-effective strategy to determine suicide risk in MDD.
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Affiliation(s)
- Ángela Velasco
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Julia Rodríguez-Revuelta
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
| | - Emilie Olié
- Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, CHU Montpellier—Inserm U1061, University of Montpellier, Montpellier, France
- Fondation FondaMental, Créteil, France
| | - Iciar Abad
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
| | | | - Aurélie Cazals
- Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, CHU Montpellier—Inserm U1061, University of Montpellier, Montpellier, France
- Fondation FondaMental, Créteil, France
| | - Sébastien Guillaume
- Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, CHU Montpellier—Inserm U1061, University of Montpellier, Montpellier, France
- Fondation FondaMental, Créteil, France
| | - Lorena de la Fuente-Tomás
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Luis Jiménez-Treviño
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
| | - Laura Gutiérrez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Paz García-Portilla
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, CHU Montpellier—Inserm U1061, University of Montpellier, Montpellier, France
- Fondation FondaMental, Créteil, France
| | - Pilar A. Sáiz
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
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15
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Abstract
Suicide morbidity and mortality are serious public health problems, accounting for over 40,000 deaths annually and over $10 billion in combined medical and work loss costs. Suicidal behavior is the outcome of a complex causal web of distal and proximal risk processes that includes a range of interacting environmental and biological determinants. We review current understanding of risk and protective factors, including recent findings on inflammatory processes, discuss recent research on environmental risks for suicidal behaviors with a focus on economic stress, and examine potential mechanisms by which external factors and internal processes such as inflammation might contribute to pathways leading to suicidal behavior. We propose a model that links changes in the default network or resting state of brain activity with corresponding changes in brain structure and function, which in turn may be influenced by diverse inflammatory mediators, and suggest a potential framework that highlights multidisciplinary opportunities for further research.
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16
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Food allergy is associated with depression and psychological distress: A web-based study in 11,876 Japanese. J Affect Disord 2019; 245:213-218. [PMID: 30408639 DOI: 10.1016/j.jad.2018.10.119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/12/2018] [Accepted: 10/24/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although some studies suggest a possible association between food allergy (FA) and depression/psychological distress, empirical data are still scarce. We aimed to examine whether this association exists in a large sample of the Japanese population. METHODS This web-based cross-sectional survey included 1000 individuals with self-reported lifetime history of clinical depression (mean age: 41.4 years, 501 men), and the remaining 10,876 subjects served as controls (mean age: 45.1 years, 5691 men). A six-item Kessler scale (K6) test was used to evaluate severe psychological distress. Information on FA was obtained by a self-report checking for 27 specific allergens. RESULTS Participants with FA, 2 or more, 3 or more, and 4 or more allergens were more common in the depression group than in the control group (odds ratio [OR] = 1.64, 1.75, 2.02, and 2.27, respectively; p < 0.001). In the allergen analyses, allergies for shrimp, egg, mackerel, crab, kiwi fruit, milk, banana, and squid (nominal, p < 0.05) were more common in the depression group than in the controls. The proportion of individuals who had a K6 test cut-off score ≥ 13 was higher in the FA group than in the non-FA group, in the total sample (OR = 1.32, 1.62, 2.04 and 2.51; 1, 2, 3, and 4 or more allergens, respectively; p < 0.001). LIMITATIONS The identification of FA and depression was based on self-reports. CONCLUSIONS Our data suggest that FA is a risk factor for depression and severe psychological distress, which depends on the number of allergens.
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17
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Langgartner D, Lowry CA, Reber SO. Old Friends, immunoregulation, and stress resilience. Pflugers Arch 2019; 471:237-269. [PMID: 30386921 PMCID: PMC6334733 DOI: 10.1007/s00424-018-2228-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/03/2018] [Accepted: 10/22/2018] [Indexed: 02/07/2023]
Abstract
There is a considerable body of evidence indicating that chronic adverse experience, especially chronic psychosocial stress/trauma, represents a major risk factor for the development of many somatic and affective disorders, including inflammatory bowel disease (IBD) and posttraumatic stress disorder (PTSD). However, the mechanisms underlying the development of chronic stress-associated disorders are still in large part unknown, and current treatment and prevention strategies lack efficacy and reliability. A greater understanding of mechanisms involved in the development and persistence of chronic stress-induced disorders may lead to novel approaches to prevention and treatment of these disorders. In this review, we provide evidence indicating that increases in immune (re-)activity and inflammation, potentially promoted by a reduced exposure to immunoregulatory microorganisms ("Old Friends") in today's modern society, may be causal factors in mediating the vulnerability to development and persistence of stress-related pathologies. Moreover, we discuss strategies to increase immunoregulatory processes and attenuate inflammation, as for instance contact with immunoregulatory Old Friends, which appears to be a promising strategy to promote stress resilience and to prevent/treat chronic stress-related disorders.
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Affiliation(s)
- Dominik Langgartner
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Christopher A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA
- Department of Physical Medicine & Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Denver Veterans Affairs Medical Center (VAMC), Denver, CO, 80220, USA
- Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO, 80220, USA
| | - Stefan O Reber
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
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18
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Bedolla-Barajas M, Pulido-Guillén NA, Vivar-Aburto B, Morales-Romero J, Ortiz-Peregrina JR, Robles-Figueroa M. Is suicidal ideation associated with allergic asthma and allergic rhinitis? ACTA ACUST UNITED AC 2019. [PMID: 29538540 PMCID: PMC6130331 DOI: 10.1590/s1806-37562017000000129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective: To investigate whether there is an association between suicidal ideation (SI) and allergic diseases in adults. Methods: This was a comparative cross-sectional study involving individuals ranging from 20 to 50 years of age recruited from a university hospital in the city of Guadalajara, Mexico. We included patients with a confirmed diagnosis of allergic asthma, those with a confirmed diagnosis of allergic rhinitis, and healthy controls. All subjects completed the Beck Depression Inventory-II (BDI-II), which includes an item that evaluates the presence of suicidal thoughts or desires within the last two weeks, in order to identify SI. Results: The sample comprised 115 patients with allergic asthma, 111 patients with allergic rhinitis, and 96 healthy controls. The number of individuals identified with SI in the three groups were, respectively, 17 (14.8%), 13 (11.7%), and 8 (8.3%). Regarding the presence of SI, no statistically significant association was found in the allergic asthma group (OR = 1.98; 95% CI: 0.78-4.64; p = 0.154) or in the allergic rhinitis group (OR = 1.46; 95% CI: 0.58-3.68; p = 0.424) when they were compared with the control group. However, the presence of depression was associated with SI in the three groups: allergic asthma (OR = 12.36; 95% CI: 2.67-57.15; p = 0.001); allergic rhinitis (OR = 6.20; 95% CI: 1.66-23.14; p = 0.006); and control (OR = 21.0; 95% CI: 3.75-117.36; p < 0,001). Conclusions: In comparison with the control group, no association was found between SI and the groups with allergic diseases. In contrast, there was association between SI and depression in the three groups.
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Affiliation(s)
- Martín Bedolla-Barajas
- . Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
| | | | - Bolívar Vivar-Aburto
- . Servicio de Medicina Interna, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
| | | | - José Raúl Ortiz-Peregrina
- . Departamento de Inhaloterapia, Neumología y Alergia, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
| | - Martín Robles-Figueroa
- . Servicio de Medicina Interna, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
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19
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Oh H, Koyanagi A, DeVylder JE, Stickley A. Seasonal Allergies and Psychiatric Disorders in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091965. [PMID: 30205581 PMCID: PMC6164754 DOI: 10.3390/ijerph15091965] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 12/22/2022]
Abstract
Seasonal allergies have been associated with mental health problems, though the evidence is still emergent, particularly in the United States. We analyzed data from the National Comorbidity Survey Replication and the National Latino and Asian American Survey (years 2001–2003). Multivariable logistic regression models were used to examine the relations between lifetime allergies and lifetime psychiatric disorders (each disorder in a separate model), adjusting for socio-demographic variables (including region of residence) and tobacco use. Analyses were also stratified to test for effect modification by race and sex. A history of seasonal allergies was associated with greater odds of mood disorders, anxiety disorders, and eating disorders, but not alcohol or substance use disorders, after adjusting for socio-demographic characteristics and tobacco use. The associations between seasonal allergies and mood disorders, substance use disorders, and alcohol use disorders were particularly strong for Latino Americans. The association between seasonal allergies and eating disorders was stronger for men than women. Seasonal allergies are a risk factor for psychiatric disorders. Individuals complaining of seasonal allergies should be screened for early signs of mental health problems and referred to specialized services accordingly.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34 th St., Los Angeles, CA 90089-0411, USA.
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Deu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain.
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, 28029 Madrid, Spain.
| | - Jordan E DeVylder
- Graduate School of Social Service, Fordham University, 113 W 60th Street, New York, NY 10023, USA.
| | - Andrew Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, 141 89 Huddinge, Sweden.
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo 1878553, Japan.
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20
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Henriksson HE, White RA, Sylvén SM, Papadopoulos FC, Skalkidou A. Meteorological parameters and air pollen count in association with self-reported peripartum depressive symptoms. Eur Psychiatry 2018; 54:10-18. [PMID: 30031991 DOI: 10.1016/j.eurpsy.2018.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 06/25/2018] [Accepted: 06/30/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Meteorological parameters and air pollen count have been associated with affective disorders and suicide. Regarding peripartum depression, the literature is restricted and inconclusive. METHODS This cross-sectional study included women (pregnant, n = 3843; postpartum, n = 3757) who participated in the BASIC (Biology, Affect, Stress, Imaging, and Cognition) study 2010-2015 and the UPPSAT (Uppsala-Athens) study (postpartum, n = 1565) in 2006-2007. Cases were defined according to presence of depressive symptoms during pregnancy (gestational week 32) and 6 weeks postpartum, using the Edinburgh Postnatal Depression Scale (EPDS). Exposure of sunshine, temperature, precipitation, snow coverage, and air pollen counts of durations of 1, 7, and 42 days prior to the outcome were studied for associations with depressive symptoms, using negative binomial regression. RESULTS Prior to Bonferroni correction, the concentration of mugwort pollen, both one week and six weeks before the EPDS assessment at gestational week 32, was inversely associated with depressive symptoms in pregnancy, both before and after adjustment for season. No associations were found between the exposure to meteorological parameters and pollen and depressive symptoms, at the same day of depressive symptoms' assessment, the previous week, or the six weeks prior to assessment, either during pregnancy or postpartum after Bonferroni correction. CONCLUSIONS There was no evidence that neither short-term nor long-term exposure to meteorological parameters or air pollen counts were associated with self-reported peripartum depressive symptoms in Uppsala, Sweden.
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Affiliation(s)
- Hanna E Henriksson
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, 75185, Uppsala, Sweden.
| | | | - Sara M Sylvén
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, 75185, Uppsala, Sweden; Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | | | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, 75185, Uppsala, Sweden
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21
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Bao Y, Chen J, Cheng L, Guo Y, Hong S, Kong W, Lai H, Li H, Li H, Li J, Li T, Lin X, Liu S, Liu Z, Lou H, Meng J, Qiu Q, Shen K, Tang W, Tao Z, Wang C, Wang X, Wei Q, Xiang L, Xie H, Xu Y, Zhang G, Zhang Y, Zheng Y, Zhi Y, Chen D, Hong H, Li Q, Liu L, Meng Y, Wang N, Wang Y, Zhou Y, Zhang L. Chinese Guideline on allergen immunotherapy for allergic rhinitis. J Thorac Dis 2017; 9:4607-4650. [PMID: 29268533 DOI: 10.21037/jtd.2017.10.112] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The present document is based on a consensus reached by a panel of experts from Chinese Society of Allergy (CSA) and Chinese Allergic Rhinitis Collaborative Research Group (C2AR2G). Allergen immunotherapy (AIT), has increasingly been used as a treatment for allergic rhinitis (AR) globally, as it has been shown to provide a long-term effect in improving nasal and ocular symptoms, reducing medication need, and improving quality of life. AIT is currently the only curative intervention that can potentially modify the immune system in individuals suffering from AR and prevent the development of new sensitization and the progression of disease from AR to asthma. Although the use of AIT is becoming more acceptable in China, to date no AR immunotherapy guideline from China is available for use by the international community. This document has thus been produced and covers the main aspects of AIT undertaken in China; including selection of patients for AIT, the allergen extracts available on the Chinese market, schedules and doses of allergen employed in different routes of AIT, assessment of effect and safety, patients' administration and follow-up, and management of adverse reactions. The Chinese guideline for AR immunotherapy will thus serve as a reference point by doctors, healthcare professionals and organizations involved in the AIT of AR in China. Moreover, this guideline will serve as a source of information for the international community on AIT treatment strategies employed in China.
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Affiliation(s)
- Yixiao Bao
- Department of Pediatric Respiratory Medicine, Pubin Children Hospital, Shanghai Children Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jianjun Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lei Cheng
- Department of Otorhinolaryngology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.,International Centre for Allergy Research, Nanjing Medical University, Nanjing 210029, China
| | - Yinshi Guo
- Department of Allergy & Immunology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Suling Hong
- Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Weijia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - He Lai
- Department of Allergy, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Houyong Li
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Huabin Li
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Jing Li
- State Key Laboratory of Respiratory Disease, Allergy and Clinical Immunology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Tianying Li
- Department of otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Xiaoping Lin
- The PLA Center of respiratory and allergic disease diagnosing and management, Shenyang 110016, China
| | - Shixi Liu
- Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zheng Liu
- Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Hongfei Lou
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China
| | - Juan Meng
- Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qianhui Qiu
- Department of Otorhinolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Kunling Shen
- Department of Pediatric Respiratory Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Wei Tang
- Department of Pulmonary and Critical Care Medicine, Shanghai Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025, China
| | - Zezhang Tao
- Department of Otolaryngology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Chengshuo Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China
| | - Xiangdong Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China
| | - Qingyu Wei
- Department of Allergy, NO.202 Hospital of PLA, Shenyang 110003, China
| | - Li Xiang
- Department of Allergy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Hua Xie
- Department of Respiratory Medicine, the General Hospital of Shenyang Military Region, Shenyang 110016, China
| | - Yu Xu
- Department of Otolaryngology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Gehua Zhang
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Yuan Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China
| | - Yiwu Zheng
- Scientific Affairs, ALK, Guangzhou 510300, China
| | - Yuxiang Zhi
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100720, China
| | - Dehua Chen
- Department of otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Haiyu Hong
- Department of otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Quansheng Li
- Department of Allergy, NO.202 Hospital of PLA, Shenyang 110003, China
| | - Lin Liu
- Department of Otorhinolaryngology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Yifan Meng
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China
| | - Nan Wang
- Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yihui Wang
- Department of Pediatric Respiratory Medicine, Pubin Children Hospital, Shanghai Children Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Yue Zhou
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China.,Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China
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22
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Bedolla-Barajas M, Morales-Romero J, Pulido-Guillén NA, Robles-Figueroa M, Plascencia-Domínguez BR. Rhinitis as an associated factor for anxiety and depression amongst adults. Braz J Otorhinolaryngol 2017; 83:432-438. [PMID: 27388955 PMCID: PMC9442713 DOI: 10.1016/j.bjorl.2016.05.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/06/2016] [Accepted: 05/16/2016] [Indexed: 12/13/2022] Open
Abstract
Introduction Anxiety and depression are frequent disorders of chronic diseases, yet there is no conclusive information to their association with rhinitis. Objective The objective is to determine the frequency of anxiety and depression and its possible association to allergic rhinitis (AR) and non-allergic rhinitis (NAR). Methods This is a cross-sectional study in which procured subjects with AR (n = 111), NAR (n = 34) and a control group (n = 96) from the university hospital. The presence of anxiety and depression was considered when it reached a score > 13 based on The Beck Anxiety Inventory Test and The Beck Depression Inventory II Test, respectively. The association between AR and NAR with anxiety and depression was adjusted with the Mantel–Haenszel Method and logistic regression. Results The frequency for anxiety in AR, NAR and the control group was 45.9%, 52.9%, 10.4%, respectively (p < 0.001); depression frequency was 38.7%, 47.1%, 16.6% (p = 0.0003), respectively. Both AR and NAR were associated to anxiety and depression in women, but not to men. After adjusting the sex: AR was associated to anxiety (OR = 5.7, p < 0.001) and depression (OR = 2.5, p = 0.015), while NAR was also associated to anxiety (OR = 7.8, p < 0.001) and depression (OR = 3.3, p < 0.014). In multivariate analysis it was identified that AR, NAR and the individual's sex (women) were factors associated to anxiety and depression. Results showed that age was only associated to anxiety. Conclusion AR and NAR are diseases associated to anxiety and depression, at least in women.
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23
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Stickley A, Sheng Ng CF, Konishi S, Koyanagi A, Watanabe C. Airborne pollen and suicide mortality in Tokyo, 2001-2011. ENVIRONMENTAL RESEARCH 2017; 155:134-140. [PMID: 28219016 DOI: 10.1016/j.envres.2017.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/25/2017] [Accepted: 02/09/2017] [Indexed: 06/06/2023]
Abstract
Prior research has indicated that pollen might be linked to suicide mortality although the few studies that have been undertaken to date have produced conflicting findings and been limited to Western settings. This study examined the association between the level of airborne pollen and suicide mortality in Tokyo, Japan in the period from 2001 to 2011. The daily number of suicide deaths was obtained from the Japanese Ministry of Health, Labour and Welfare, with pollen data being obtained from the Tokyo Metropolitan Institute of Public Health. A time-stratified case-crossover study was performed to examine the association between different levels of pollen concentration and suicide mortality. During the study period there were 5185 male and 2332 female suicides in the pollen season (February to April). For men there was no association between airborne pollen and suicide mortality. For women, compared to when there was no airborne pollen, the same-day (lag 0) pollen level of 30 to <100 grains per cm2 was associated with an approximately 50% increase in the odds for suicide (e.g. 30 to <50 grains per cm2: odds ratio 1.574, 95% confidence interval 1.076-2.303, p=0.020). The estimates remained fairly stable after adjusting for air pollutants and after varying the cut-points that defined the pollen levels. Our results indicate that pollen is associated with female suicide mortality in Tokyo.
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Affiliation(s)
- Andrew Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden.
| | - Chris Fook Sheng Ng
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Shoko Konishi
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Anthropology, University of Washington, Box 353100, Seattle, WA 98195, USA
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas,, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Chiho Watanabe
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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24
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Mental Health in Allergic Rhinitis: Depression and Suicidal Behavior. CURRENT TREATMENT OPTIONS IN ALLERGY 2017; 4:71-97. [PMID: 28966902 DOI: 10.1007/s40521-017-0110-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A high proportion of suicides visit their medical provider in the month prior to death, but depression, suicidal thoughts, and substance use are seldom addressed. For the clinicians routinely treating a substantial patient population with allergic diseases, there are additional concerns, as allergy has been linked with both depression and suicidal behavior. While psychotropic medications may affect diagnosis of allergies, medications used to treat allergies impact mood and behavior. Thus, we present an overview of the overlap of allergic rhinitis with depression and suicidal behavior in adults, based on clinical and epidemiological data, and our research and clinical experience. In summary, we suggest: 1) inquiring among patients with allergies about personal and family history of depression, substance use disorders, suicidal ideation and attempts 2) increased mindfulness regarding the potential effects of allergy medications on mood and behavior; and 3) for people identified with certain types of depression or increased suicide risk, a systematic multilevel collaborative approach. While for practical reasons the majority of patients with depression will continue to be treated by general or family practitioners, the allergy-treating provider should always consider integrated care for bipolar, psychotic or suicidal depression and incomplete remission, or relapsing and highly recurrent course. While awaiting results of much needed basic and clinical research to guide clinical approach for patients with comorbid allergic rhinitis and depression, the simple steps recommended here are expected to improved clinical outcomes in depression, including, on a large scale, reduced premature deaths by suicide.
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25
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Li L, Cheng WY, Glicksberg BS, Gottesman O, Tamler R, Chen R, Bottinger EP, Dudley JT. Identification of type 2 diabetes subgroups through topological analysis of patient similarity. Sci Transl Med 2016; 7:311ra174. [PMID: 26511511 DOI: 10.1126/scitranslmed.aaa9364] [Citation(s) in RCA: 311] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Type 2 diabetes (T2D) is a heterogeneous complex disease affecting more than 29 million Americans alone with a rising prevalence trending toward steady increases in the coming decades. Thus, there is a pressing clinical need to improve early prevention and clinical management of T2D and its complications. Clinicians have understood that patients who carry the T2D diagnosis have a variety of phenotypes and susceptibilities to diabetes-related complications. We used a precision medicine approach to characterize the complexity of T2D patient populations based on high-dimensional electronic medical records (EMRs) and genotype data from 11,210 individuals. We successfully identified three distinct subgroups of T2D from topology-based patient-patient networks. Subtype 1 was characterized by T2D complications diabetic nephropathy and diabetic retinopathy; subtype 2 was enriched for cancer malignancy and cardiovascular diseases; and subtype 3 was associated most strongly with cardiovascular diseases, neurological diseases, allergies, and HIV infections. We performed a genetic association analysis of the emergent T2D subtypes to identify subtype-specific genetic markers and identified 1279, 1227, and 1338 single-nucleotide polymorphisms (SNPs) that mapped to 425, 322, and 437 unique genes specific to subtypes 1, 2, and 3, respectively. By assessing the human disease-SNP association for each subtype, the enriched phenotypes and biological functions at the gene level for each subtype matched with the disease comorbidities and clinical differences that we identified through EMRs. Our approach demonstrates the utility of applying the precision medicine paradigm in T2D and the promise of extending the approach to the study of other complex, multifactorial diseases.
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Affiliation(s)
- Li Li
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 700 Lexington Ave., New York, NY 10065, USA
| | - Wei-Yi Cheng
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 700 Lexington Ave., New York, NY 10065, USA
| | - Benjamin S Glicksberg
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 700 Lexington Ave., New York, NY 10065, USA
| | - Omri Gottesman
- Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Ronald Tamler
- Division of Endocrinology, Diabetes, and Bone Diseases, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Rong Chen
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 700 Lexington Ave., New York, NY 10065, USA
| | - Erwin P Bottinger
- Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Joel T Dudley
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 700 Lexington Ave., New York, NY 10065, USA. Department of Health Policy and Research, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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26
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Noh HM, Cho JJ, Park YS, Kim JH. The relationship between suicidal behaviors and atopic dermatitis in Korean adolescents. J Health Psychol 2016; 21:2183-94. [DOI: 10.1177/1359105315572453] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Atopic dermatitis is a common skin disease in adolescents, which may have a negative effect on the mental and emotional health. We investigated the relationship between atopic dermatitis and suicidal behaviors in Korean adolescents. Participants included 74,186 adolescents (38,221 boys and 35,965 girls) in middle and high school who completed the Eighth Korea Youth Risk Behavior Web-Based Survey. There were significant associations between atopic dermatitis and suicidal behaviors for girls. The overestimation of weight perception might have an additive impact on suicidal risk among girls. However, there were no significant associations between atopic dermatitis and suicidal behaviors in boys.
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Affiliation(s)
- Hye-Mi Noh
- Hallym University College of Medicine, Korea
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27
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Xi L, Cao F, Zhang Y, Zhang L. Severity of nasal obstruction can predict the anxiety status of patients with allergic rhinitis but not patients with vasomotor rhinitis. Int Forum Allergy Rhinol 2016; 6:1196-1203. [PMID: 27277070 DOI: 10.1002/alr.21802] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 04/21/2016] [Accepted: 04/26/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Lin Xi
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital; Capital Medical University; Beijing China
- Beijing Key Laboratory of Nasal Diseases; Beijing Institute of Otolaryngology; Beijing China
- Institute of Psychology; Chinese Academy of Sciences; Beijing China
- Department of Allergy, Beijing TongRen Hospital; Capital Medical University; Beijing China
| | - Feifei Cao
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital; Capital Medical University; Beijing China
- Beijing Key Laboratory of Nasal Diseases; Beijing Institute of Otolaryngology; Beijing China
- Department of Allergy, Beijing TongRen Hospital; Capital Medical University; Beijing China
| | - Yuan Zhang
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital; Capital Medical University; Beijing China
- Beijing Key Laboratory of Nasal Diseases; Beijing Institute of Otolaryngology; Beijing China
- Department of Allergy, Beijing TongRen Hospital; Capital Medical University; Beijing China
| | - Luo Zhang
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital; Capital Medical University; Beijing China
- Beijing Key Laboratory of Nasal Diseases; Beijing Institute of Otolaryngology; Beijing China
- Department of Allergy, Beijing TongRen Hospital; Capital Medical University; Beijing China
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28
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Kim DH, Han K, Kim SW. Relationship Between Allergic Rhinitis and Mental Health in the General Korean Adult Population. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2016; 8:49-54. [PMID: 26540501 PMCID: PMC4695408 DOI: 10.4168/aair.2016.8.1.49] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/26/2015] [Indexed: 12/28/2022]
Abstract
PURPOSE This study was conducted to evaluate the association between AR and mental health status in the general Korean adult population and to investigate the relative burden of AR on mental health using the Allergic Rhinitis and Its Impact on Asthma (ARIA) classification. METHODS A cross-sectional study was performed by using data from 11,154 individuals, 19 years old or older in the Korean National Health and Nutrition Examination Survey 2011-2012. Univariate analysis was conducted in the healthy AR groups with weighted prevalence of demographic characteristics, socioeconomic status, and comorbid diseases. Subanalysis that classified AR severity according to the ARIA classification was carried out to evaluate the relationship of AR severity with mental health. The odds ratios (ORs) for each component representing mental health status were estimated by multiple logistic regression analysis with confounder adjustment. RESULTS Univariate analysis with the chi-square test after adjustment for age, sex, body mass index, smoking status, alcohol use status, and exercise status, components representing mental health status showed a linear relationship with the severity of AR according to the ARIA classification. Stress, depressive mood, suicidal thoughts, and psychological consultation factors were correlated with AR after adjustment for demographic characteristics and socioeconomic status. Even after adjustment for comorbid allergic diseases, the correlation remained significant with stress, depressive mood, and psychological consultation factors (OR [95% CI]; 1.227 [1.042, 1.445], 1.368 [1.095, 1.71], 1.804 [1.096, 2.969], respectively). CONCLUSIONS Patients with AR appear to be at higher risk of mental disorders in the general Korean adult population. Moreover, persistent or severe AR was correlated with poor mental health. Therefore, better control of AR may be conducive to better mental health, and more attention should be paid to the psychological status of AR patients.
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Affiliation(s)
- Do Hyun Kim
- Department of Otorhinolaryngology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, The Catholic University of Korea, Seoul, Korea
| | - Soo Whan Kim
- Department of Otorhinolaryngology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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29
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Ganança L, Oquendo MA, Tyrka AR, Cisneros-Trujillo S, Mann JJ, Sublette ME. The role of cytokines in the pathophysiology of suicidal behavior. Psychoneuroendocrinology 2016; 63:296-310. [PMID: 26546783 PMCID: PMC4910882 DOI: 10.1016/j.psyneuen.2015.10.008] [Citation(s) in RCA: 145] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/18/2015] [Accepted: 10/13/2015] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Immune dysregulation has been implicated in depression and other psychiatric disorders. What is less clear is how immune dysregulation can affect risk of suicidal behavior. We reviewed the scientific literature concerning cytokines related to suicidal ideation, suicidal behavior and suicide, and surveyed clinical and neurobiological factors associated with cytokine levels that may modulate effects of inflammation on suicide risk. METHODS We searched PubMed, Embase, Scopus and PsycINFO for relevant studies published from 1980 through February, 2015. Papers were included if they were written in English and focused on cytokine measurements in patients with suicidal behaviors. RESULTS The literature search yielded 22 studies concerning cytokines and suicidal ideation, suicide attempts or suicide completion. The most consistent finding was elevated interleukin (IL)-6, found in 8 out of 14 studies, in CSF, blood, and postmortem brain. In one study, IL-6 in CSF was also found to be higher in violent than nonviolent attempters and to correlate with future suicide completion. Low plasma IL-2 was observed in 2 studies of suicide attempters, while divergent results were seen for tumor necrosis factor (TNF)-α, interferon (IFN)-γ, transforming growth factor (TGF)-β, IL-4, and soluble Il-2 receptors. CONCLUSIONS Given the complexity suggested by the heterogenous cytokine findings, putative mediators and moderators of inflammation on suicidal behavior merit further study. Elevated IL-6 was the most robust cytokine finding, associated with suicidal ideation and both nonfatal suicide attempts and suicides. Future studies should evaluate the predictive value of high IL-6, consider how this may alter brain function to impact suicidal behavior, and explore the potential beneficial effects of reducing IL-6 on suicide risk.
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Affiliation(s)
- Licínia Ganança
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, 10032 NY, USA,Department of Psychiatry, Columbia University, New York, 10032 NY, USA,Department of Psychiatry, School of Medicine, University of Lisbon, 1649-035 Lisbon, Portugal
| | - Maria A. Oquendo
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, 10032 NY, USA,Department of Psychiatry, Columbia University, New York, 10032 NY, USA
| | - Audrey R. Tyrka
- Laboratory for Clinical and Translational Neuroscience, Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, 02912 RI, USA
| | - Sebastian Cisneros-Trujillo
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, 10032 NY, USA,Department of Psychiatry, Columbia University, New York, 10032 NY, USA
| | - J. John Mann
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, 10032 NY, USA,Department of Psychiatry, Columbia University, New York, 10032 NY, USA,Department of Radiology, Columbia University, New York, 10032 NY, USA
| | - M. Elizabeth Sublette
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, 10032 NY, USA,Department of Psychiatry, Columbia University, New York, 10032 NY, USA,Corresponding author: New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, NY, NY 10032. Tel: (646) 774-7514; Fax: (646) 774-7589
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30
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Courtet P, Jaussent I, Genty C, Dupuy AM, Guillaume S, Ducasse D, Olié E. Increased CRP levels may be a trait marker of suicidal attempt. Eur Neuropsychopharmacol 2015; 25:1824-31. [PMID: 26032768 DOI: 10.1016/j.euroneuro.2015.05.003] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 05/11/2015] [Indexed: 01/06/2023]
Abstract
Suicide is a leading cause of death worldwide. Identifying biomarkers will help enhance our understanding of suicidal pathophysiology and improve its prevention. Therefore, we investigated CRP levels in 600 depressed inpatients: 520 patients had a lifetime history of suicide attempts and 80 patients did not have any history of suicide attempts. For all patients, we assessed socio-demographic features, lifetime Axis I DSM-IV diagnoses, depression intensity, suicidal ideation, characteristics of suicidal history, and history of childhood trauma. The day following admission, fasting blood tests yielded samples collected for the measurement of high sensitivity hs-CRP. CRP levels were associated with a history of suicide attempts. The risk of suicide attempts increased with higher levels of CRP in a dose-response way before and after adjustments for age, gender, chronic diseases, addiction and anxiety comorbidities, antidepressants use, smoking status and sexual abuse. Noteworthy, the association between CRP levels and history of suicide attempts remained significant after having excluded patients with chronic diseases. There was no significant difference in CRP levels between patients who attempted suicide more or less than a week before plasma sampling, and no significant difference in CRP levels was evidenced between high vs low suicidal ideation. In conclusion, this is the first study suggesting that CRP may be a trait marker for suicidal vulnerability by associating CRP levels and a lifetime history of suicide attempts in depressed inpatients. Therefore, determining the inflammatory marker profile of individuals exhibiting suicidal behaviors could be relevant for anticipating behaviors and refining new therapeutic opportunities.
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Affiliation(s)
- Ph Courtet
- CHU Montpellier, HôpitalLapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, France; Inserm, U1061 Montpellier,University of Montpellier, Montpellier, France; FondaMental Foundation, France
| | - I Jaussent
- Inserm, U1061 Montpellier,University of Montpellier, Montpellier, France; FondaMental Foundation, France
| | - C Genty
- CHU Montpellier, HôpitalLapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, France; Inserm, U1061 Montpellier,University of Montpellier, Montpellier, France; FondaMental Foundation, France
| | - A M Dupuy
- Inserm, U1061 Montpellier,University of Montpellier, Montpellier, France; Department of Biochemistry, CHRU de Montpellier, Montpellier, France
| | - S Guillaume
- CHU Montpellier, HôpitalLapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, France; Inserm, U1061 Montpellier,University of Montpellier, Montpellier, France; FondaMental Foundation, France
| | - D Ducasse
- CHU Montpellier, HôpitalLapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, France; Inserm, U1061 Montpellier,University of Montpellier, Montpellier, France; FondaMental Foundation, France.
| | - E Olié
- CHU Montpellier, HôpitalLapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, France; Inserm, U1061 Montpellier,University of Montpellier, Montpellier, France; FondaMental Foundation, France
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31
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Lee D, Seo JY, Lee CS, Park CS, Kim BJ, Cha B, Lee SJ. Allergic diseases, excessive Internet use and suicidal ideation in Korean adolescents. Compr Psychiatry 2015; 62:100-4. [PMID: 26343473 DOI: 10.1016/j.comppsych.2015.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/01/2015] [Accepted: 06/17/2015] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate the relation between suicidal ideation, allergic diseases, and excessive Internet use in Korean youth using a national representative dataset. METHODS Data from the Korean Youth Risk Behavior Web-Based Survey (KYRBWS), conducted by the Korean Centers for Disease Control and Prevention, were used in this study. Complex sample logistic regression and structural equation modeling were performed to define the relation between suicidal ideation, allergic disease and excessive Internet use. RESULTS A total of 73,238 students participated in this survey. In Korea, 19.3% of adolescents had suicidal ideation in the previous year. Asthma (OR=1.23, 95% CI=1.15-1.32, p<0.01) and allergic rhinitis (OR=1.17, 95% CI=1.11-1.22, p<0.01) were identified as risk factors for suicidal ideation after adjusting for school and family factors. Structural equation modeling showed that excessive Internet use interacted with the association between allergic diseases and suicidal ideation. CONCLUSION Allergy problems could positively affect suicidal ideation in Korean adolescents. Excessive Internet use could be a mediating factor between allergic disease and suicidal ideation.
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Affiliation(s)
- Dongyun Lee
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Ji-Yeong Seo
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Cheol-Soon Lee
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea.
| | - Chul-Soo Park
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Bong-Jo Kim
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Boseok Cha
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - So-Jin Lee
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
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Abstract
A high rate of ENT doctors were murdered by nasal disordered patients in China recently. It is obviously important and urgent to find out whether there is any potential relationship between nasal diseases (ND) and psychological distress that might contribute to violent behavior. For this purpose, we carried out this literature review. There is a complex relationship between ND and psychiatric distress, which is mainly considered as a bidirectional causal relationship with other controversy opinions. However, most of the previous studies were found to be focused on allergic rhinitis and chronic rhinosinusitis, while reports about other ND were rare. Further study is still needed to uncover the secret aspects in this field, and more attentions need to be paid to other ND.
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Affiliation(s)
- Deping Wang
- a Department of Otorhinolaryngology-Head and Neck Surgery , The Second Affiliated Hospital of Chongqing Medical University , Chongqing 400010 , China
| | - Wenlong Luo
- a Department of Otorhinolaryngology-Head and Neck Surgery , The Second Affiliated Hospital of Chongqing Medical University , Chongqing 400010 , China
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Zhang Y, Zhen H, Yao W, Bian F, Mao X, Yang X, Jin S. Antidepressant drug, desipramine, alleviates allergic rhinitis by regulating Treg and Th17 cells. Int J Immunopathol Pharmacol 2013; 26:107-15. [PMID: 23527713 DOI: 10.1177/039463201302600110] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Allergic rhinitis (AR) is characterized by IgE-mediated immediate hypersensitivity and usually progresses to chronic nasal inflammation, with depression as one of its comorbidities. The importance of treating the depression in AR patients has been increasingly recognized. Desipramine is a representative of tricyclic-antidepressant agents. In the present study we investigate whether desipramine has therapeutic effects on AR inflammation. BALB/C mice were sensitized by intraperitoneal injection of ovalbumin (OVA), followed by repeated challenge with OVA intranasally. Desipramine was administered orally to treat the mice. The nasal symptoms (sneezing, nasal scratching etc.) of AR were evaluated to determine the severity of AR. Cytokines in the nasal lavage fluid (NALF), including interferon-gamma (IFN-gamma), interleukin 4 (IL-4) and serum OVA-specific immunoglobulin E (IgE) antibody were measured by ELISA. The regulatory T cells (Treg) and T helper cells 17 (Th17) were quantified by flow cytometric analysis. As a result, the repeated oral administration of desipramine attenuated the nasal symptoms (sneezing and nasal rubbing) in AR mice. Desipramine also suppressed the serum OVA-specific IgE and IL-4 levels, but had no effect on IFN-gamma level. Moreover, desipramine treatment up regulated CD4+CD25+Foxp3+ Treg cells, which were found down-regulated in established AR mice. Meanwhile, desipramine administration attenuated CD4+IL-17+ Th17 cells, which were significantly increased in AR mice. These results suggest that the antidepressant drug, desipramine, also has anti-allergic action, which was possibly achieved by reducing allergen-specific IgE and Th2 cytokine production and maintaining a balance between Treg and Th17 cells. Thus, this study provide the first evidence that desipramine may be utilized to treat allergic diseases, especially for those allergic patients with depression or depression patients with allergy.
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Affiliation(s)
- Y Zhang
- Department of Pharmacology, Huazhong University of Science and Technology, China
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Pacheco Y, Freymond N, Devouassoux G. Impact of montelukast on asthma associated with rhinitis, and other triggers and co-morbidities. J Asthma 2013; 51:1-17. [PMID: 23834429 DOI: 10.3109/02770903.2013.822081] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Rhinitis and other specific triggers or co-morbidities (tobacco exposure, excess weight, aspirin sensitivity or heredity factors) are frequently associated with uncontrolled asthma. Asthma associated with these exacerbating factors appears to be related to an increase in leukotriene-mediated inflammation. METHODS We reviewed the role of montelukast, a leukotriene receptor antagonist, in the treatment of asthma associated with these factors by using the PubMed database to search the English and French biomedical literature for articles describing randomized-controlled trials, large observational studies and reviews (published up to May 2012, inclusive). RESULTS Montelukast, either alone or in combination with other drugs, is an effective treatment against rhinitis-associated asthma. Montelukast also offers therapeutic benefits against exercise-induced asthma or in cases of asthma linked to tobacco exposure, excess weight or aspirin hypersensitivity. Thus, for some patients, montelukast may constitute an alternative to the gold-standard treatment of inhaled corticosteroids. Polymorphisms in several genes encoding proteins of the leukotriene signaling pathway may contribute to the variability in response to montelukast. CONCLUSIONS In conclusion, we have shown that montelukast treatment could be of particular benefit to subgroups of patients with asthma associated with rhinitis, exercise, tobacco exposure, being overweight or aspirin hypersensitivity.
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Affiliation(s)
- Yves Pacheco
- Department of Respiratory Diseases, Centre Hospitalier Lyon Sud , and
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Erkul E, Cingi C, Özçelik Korkmaz M, Çekiç T, Çukurova I, Yaz A, Erdoğmuş N, Bal C. Effects of escitalopram on symptoms and quality of life in patients with allergic rhinitis. Am J Rhinol Allergy 2013; 26:e142-6. [PMID: 23168146 DOI: 10.2500/ajra.2012.26.3819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Insufficient response to treatment and declining quality of life illustrate the continuing need to find new treatment modalities for allergic rhinitis (AR). The purpose of this study was to assess how escitalopram affects symptoms and quality of life among AR patients. METHODS This study included 120 patients with AR, who were divided into four treatment groups of 30 patients each. Patients were assessed before treatment and at the end of the 3rd month based on nasal symptom scores, otorhinolaryngological examination, the Rhinoconjunctivitis Quality of Life Questionnaire, and the Beck Depression and Anxiety Inventory. All patients received standardized treatments. Group A patients with positive Beck Depression and Anxiety Inventory scores received escitalopram, and group B patients with positive Beck Depression and Anxiety Inventory scores received placebo. Group C patients with negative Beck Depression and Anxiety Inventory scores received escitalopram, and group D patients with negative Beck Depression and Anxiety Inventory scores received placebo. RESULTS Anxiety scores pre- and posttreatment revealed a statistically significant reduction in groups A, C, and D. All four groups exhibited reduced posttreatment scores for sleep, nonnasal and noneye symptoms, eye symptoms, and emotions. A statistically significant difference appeared between groups A and B in terms of general complaints and nasal symptom scores. CONCLUSION The positive effects of escitalopram on posttreatment quality of life in the Beck-positive patient group were a predictable outcome. Otolaryngologists should pay more attention to the moods of their patients with AR while they evaluate treatment during clinical follow-up visits.
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Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology, GATA Haydarpasa Training Hospital, Istanbul, Turkey.
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Mann JJ. The serotonergic system in mood disorders and suicidal behaviour. Philos Trans R Soc Lond B Biol Sci 2013; 368:20120537. [PMID: 23440471 DOI: 10.1098/rstb.2012.0537] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
A stress-diathesis explanatory model of suicidal behaviour has proved to be of heuristic value, and both clinical and neurobiological components can be integrated into such a model. A trait deficiency in serotonin input to the anterior cingulate and ventromedial prefrontal cortex is found in association with suicide, and more recently non-fatal suicidal behaviour, and is linked to decision-making and suicide intent by imaging and related studies in vivo. The same neural circuitry and serotonin deficiency may contribute to impulsive aggressive traits that are part of the diathesis for suicidal behaviour and are associated with early onset mood disorders and greater risk for suicidal behaviour. Other brain areas manifest deficient serotonin input, that is, a trait related to recurrent major depressive disorder and bipolar disorder. Thus the serotonin system is involved in both the diathesis for suicidal behaviour in terms of decision-making, and to a major stressor, namely episodes of major depression.
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Affiliation(s)
- J John Mann
- Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY 10471, USA.
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Patusky KL, Caldwell B, Unkle D, Ruck B. Incorporating the treatment of medical and psychiatric disorders in the critical care area. Crit Care Nurs Clin North Am 2012; 24:53-80. [PMID: 22405712 DOI: 10.1016/j.ccell.2012.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Critical care areas are fast moving, often chaotic, and therefore confusing, even frightening, to patients attempting to understand what has happened to them. The nurse acts to mitigate these reactions by understanding the range of possibilities that can occur with patients, including potential psychiatric issues, and serving as patient advocate to ensure that appropriate treatment is initiated. Certainly there may be other psychiatric problems not described in the preceding text. The main possibilities are covered in this article. Assessing and acting early are tools the critical care nurse uses to meet patient needs and prevent behavioral problems that can interfere with life-preserving care.
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Affiliation(s)
- Kathleen L Patusky
- Graduate Programs, School of Nursing, University of Medicine & Dentistry of New Jersey, Newark, NJ 07101, USA.
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Manalai P, Hamilton RG, Langenberg P, Kosisky SE, Lapidus M, Sleemi A, Scrandis D, Cabassa JA, Rogers CA, Regenold WT, Dickerson F, Vittone BJ, Guzman A, Balis T, Tonelli LH, Postolache TT. Pollen-specific immunoglobulin E positivity is associated with worsening of depression scores in bipolar disorder patients during high pollen season. Bipolar Disord 2012; 14:90-8. [PMID: 22329476 PMCID: PMC3293700 DOI: 10.1111/j.1399-5618.2012.00983.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE An association between allergic disease and depression has been consistently reported, but whether the key mediating ingredients are predominantly biological, psychological, or mere artifacts remains unknown. In the current study, we examined a hypothesized relationship between allergen-specific immunoglobulin E (IgE) status and changes in allergy symptoms with worsening in depression scores. METHODS In patients with recurrent mood disorders, we individually coupled sensitization to specific seasonal aeroallergens (as assessed by allergen-specific IgE) with temporal windows of exposure to aeroallergens (low versus high tree or ragweed pollen counts, measured according to the National Allergy Bureau guidelines). We compared Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorder Version (SIGH-SAD) depression score changes in 41 patients with mood disorders [25 with major depression and 16 with bipolar I disorder, diagnosed by Structured Clinical Interview for DSM (SCID)] seropositive for tree or ragweed pollen-specific IgE antibody versus 53 patients with mood disorders (30 with major depression and 23 with bipolar I disorder) seronegative for aeroallergen-specific IgE. RESULTS Worsening in total depressive scores from low to high pollen exposure was greater in allergen-specific IgE-positive patients as compared to allergen-specific IgE antibody-negative patients (p = 0.01). When stratified by polarity, the association was significant only in patients with bipolar I disorder (p = 0.004). This relationship was resilient to adjustment for changes in allergy symptom scores. CONCLUSION To our knowledge, this is the first report of coupling a molecular marker of vulnerability (allergen-specific IgE) with a specific environmental trigger (airborne allergens) leading to exacerbation of depression in patients with bipolar I disorder.
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Affiliation(s)
- Partam Manalai
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland at Baltimore, Baltimore, MD, USA
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Schumock GT, Lee TA, Joo MJ, Valuck RJ, Stayner LT, Gibbons RD. Association between leukotriene-modifying agents and suicide: what is the evidence? Drug Saf 2011; 34:533-44. [PMID: 21663330 DOI: 10.2165/11587260-000000000-00000] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The US FDA has issued safety alerts and required manufacturers of leukotriene-modifying agents (LTMAs), including montelukast, zafirlukast and zileuton, to include suicide and neuropsychiatric events as a precaution in the drug label. This paper reviews the existing evidence on the potential association between the LTMAs and suicidal behaviour. We conducted a literature search of MEDLINE, EMBASE and International Pharmaceutical Abstracts from 1995 to 2010 (inclusive) to identify pertinent studies and reports. We also examined data obtained from the FDA adverse event reporting system. To date, there are no well conducted, comparative, observational studies of this association, and the safety alerts are based primarily on case reports. While the FDA safety alerts apply to all three LTMAs, montelukast (known by its trade name Singulair®) is by far the most widely used of these drugs and most of the reports to date regarding suicide pertain to montelukast. From 1998 to 2009 there were 838 suicide-related adverse events associated with leukotrienes reported to the FDA, of which all but five involved montelukast. Nearly all cases were reported in 2008 and 2009 (96.1%) after the FDA warnings. LTMAs are approved for use in asthma and allergic rhinitis, and are effective drugs. Both of these diseases are also associated with suicide, making confirmation of the association more difficult. Given the lack of good evidence, we recommend that a large observational cohort or case-control study be conducted to quantify the association between LTMAs and suicide. Until then, when prescribing LTMAs, clinicians should consider the potential for suicide and monitor patients who may be at elevated risk carefully for suicidal ideation or psychiatric symptoms associated with suicidal behaviour.
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Affiliation(s)
- Glen T Schumock
- Center for Pharmacoeconomic Research, University of Illinois at Chicago, USA.
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Schumock GT, Gibbons RD, Lee TA, Joo MJ, Valuck RJ, Stayner LT. Relationship between leukotriene-modifying agent prescriptions dispensed and rate of suicide deaths by county in the US. Drug Healthc Patient Saf 2011; 3:47-52. [PMID: 22046105 PMCID: PMC3202760 DOI: 10.2147/dhps.s23665] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The US Food and Drug Administration has issued warnings about a potential link between leukotriene receptor-modifying agents (LTMA) and suicide. These warnings are based on case reports and there is controversy about the association. While spontaneous reporting of suicide-related events attributed to LTMA has risen dramatically, these data may be biased by the warnings. The objective of this study was to explore the relationship between LTMA and suicide deaths using event data preceding the Food and Drug Administration warnings. METHODS We conducted a mixed-effects Poisson regression analysis of the association between LTMA prescriptions dispensed and suicide deaths at the county level. Counts of suicide deaths in each US county, stratified by race, age group, gender, and year were obtained from the National Center for Health Statistics for the period January 1, 1999 to December 31, 2006. Counts of LTMA prescriptions dispensed in each US county were obtained from IMS Health Incorporated. The model estimated the overall suicide rate conditional on LTMA use, adjusted for age, gender, race, year, and antidepressant utilization. We also assessed the intracounty and intercounty associations. RESULTS There were 249,872 suicides in the US between 1999 and 2006, and the annual suicide rate ranged from 11.17 to 11.92 per 100,000 population. There were 118.63, 11.68, and 0.12 million prescriptions dispensed for montelukast, zafirlukast, and zileuton, respectively, between 1999 and 2006. The mean rate of LTMA prescriptions dispensed by county was 42.91 (95% confidence interval [CI] 42.78-43.04), 4.82 (95% CI 4.81-4.84), and 0.05 (95% CI 0.05-0.05) per 1000 for montelukast, zafirlukast, and zileuton, respectively. We found a negative within-county association between the rate of total LTMA prescriptions dispensed and the suicide rate by county (P = 0.0296). This association was primarily driven by montelukast. CONCLUSION Our results, while subject to certain limitations, provide preliminary evidence that the association between LTMA and suicide could be different (ie, reduced risk) than that which might be anticipated based on previous warnings. Patient-level research is needed to understand more clearly the association between LTMA and suicide.
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Affiliation(s)
- Glen T Schumock
- Center for Pharmacoeconomic Research, and Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - Robert D Gibbons
- Center for Health Statistics, and Departments of Medicine and Health Studies, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Todd A Lee
- Center for Pharmacoeconomic Research, and Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
- Center for Management of Complex Chronic Care, Hines VA Hospital, Hines, IL, USA
- Section of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Min J Joo
- Section of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Robert J Valuck
- Department of Clinical Pharmacy, School of Pharmacy, University of Colorado, Aurora, CO, USA
| | - Leslie T Stayner
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
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Allergic rhinitis: an update on disease, present treatments and future prospects. Int Immunopharmacol 2011; 11:1646-62. [PMID: 21784174 DOI: 10.1016/j.intimp.2011.07.005] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 06/21/2011] [Accepted: 07/06/2011] [Indexed: 11/20/2022]
Abstract
Allergic rhinitis (AR) is an inflammation of nasal mucosa mediated by IgE-associated processes occurring independently, or concurrently with asthma. AR is characterized by sensitization-formation and expression of antigen specific IgE, followed by inflammation in two phases. The early phase response involves cross linking of IgE molecules leading to degranulation of mast cells and release of preformed mediators such as histamine and tryptase, or newly synthesized mediators such as prostaglandins and leukotrienes. The late phase response is predominated by the presence of eosinophils, lymphocytes, cytokines, and adhesion molecules. Newer insights reveal that the whole phenomenon of immunological inflammation is intricately knit with neural pathways, which strongly influence the process. Furthermore, AR can impact psychological health and vice versa. Classical pharmacotherapy of AR includes use of oral or topical antihistamines, oral antileukotrienes, topical corticosteroids, mast cell stabilizers, decongestants, and an anticholinergic agent. Among immunomodulatory treatments, immunotherapy is gaining widespread use, while antibody treatment is restricted mainly to resistant cases. Several small molecules with improved safety profile, or targeting novel mechanisms are in the clinical research. Newer antihistamines and corticosteroids with improved safety profile and antagonists of the prostaglandin D(2) (CRTH2) receptors are likely to be available for clinical use in the near future. Lack of properly validated animal models and complexities associated with clinical evaluation are some of the challenges facing the researchers in AR. Comprehensive understanding of immunological and neurological processes in AR would facilitate the future quest for more effective and safer management of this disease.
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Yang AC, Tsai SJ, Huang NE, Peng CK. Association of Internet search trends with suicide death in Taipei City, Taiwan, 2004-2009. J Affect Disord 2011; 132:179-84. [PMID: 21371755 DOI: 10.1016/j.jad.2011.01.019] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2010] [Revised: 01/30/2011] [Accepted: 01/30/2011] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although Internet has become an important source for affected people seeking suicide information, the connection between Internet searches for suicide information and suicidal death remains largely unknown. This study aims to evaluate the association between suicide and Internet searches trends for 37 suicide-related terms representing major known risks of suicide. METHODS This study analyzes suicide death data in Taipei City, Taiwan and corresponding local Internet search trend data provided by Google Insights for Search during the period from January 2004 to December 2009. The investigation uses cross correlation analysis to estimate the temporal relationship between suicide and Internet search trends and multiple linear regression analysis to identify significant factors associated with suicide from a pool of search trend data that either coincides or precedes the suicide death. RESULTS Results show that a set of suicide-related search terms, the trends of which either temporally coincided or preceded trends of suicide data, were associated with suicide death. These search factors varied among different suicide samples. Searches for "major depression" and "divorce" accounted for, at most, 30.2% of the variance in suicide data. When considering only leading suicide trends, searches for "divorce" and the pro-suicide term "complete guide of suicide," accounted for 22.7% of variance in suicide data. CONCLUSIONS Appropriate filtering and detection of potentially harmful source in keyword-driven search results by search engine providers may be a reasonable strategy to reduce suicide deaths.
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Affiliation(s)
- Albert C Yang
- Department of Psychiatry, Chu-Tung Veterans Hospital, Hsin-Chu County, Taiwan.
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Ozek E, Ekici B. Asthma and suicide: possible role of brain-derived neurotrophic factor. Med Hypotheses 2011; 77:261-2. [PMID: 21570198 DOI: 10.1016/j.mehy.2011.04.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 04/11/2011] [Accepted: 04/23/2011] [Indexed: 11/17/2022]
Abstract
The suicide rates among asthmatic patients are higher than among the general population. Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family and is strongly associated with suicide pathogenesis. BDNF also plays an important role in neuroimmune reactions in allergic diseases such as asthma. Therefore, we hypothesize that alterations of BDNF levels in the brain may explain the increased suicide rates among asthmatic patients.
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Affiliation(s)
- Esra Ozek
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Pediatric Allergy and Immunology, Fatih/Istanbul, Turkey.
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Qin P, Mortensen PB, Waltoft BL, Postolache TT. Allergy is associated with suicide completion with a possible mediating role of mood disorder - a population-based study. Allergy 2011; 66:658-64. [PMID: 21143241 DOI: 10.1111/j.1398-9995.2010.02523.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND With increasing research suggesting a role of allergy on suicidality, this study, on a population level, delved into how allergy affects risk for suicide completion in the context of mood disorder and other factors. METHODS Based on the entire population of Denmark, we included 27,096 completed suicides and 467,571 live controls matched on sex and age with a nested case-control design. We retrieved personal information on hospital contacts for allergy and other variables from various Danish longitudinal registries and analyzed the data with conditional logistic regression. RESULTS We noted that 1.17% suicide victims, compared with 0.79% matched controls, had a history of hospital contact for allergy and that a history of allergy predicted an increased risk for suicide completion; however, the effect was confined to allergy that led to inpatient treatment (IRR: 1.59, 95% CI: 1.41-1.80). The increased risk was attenuated somewhat but remained significant when adjusted for personal psychiatric history and socioeconomic status. Meanwhile, we observed a nonsignificantly stronger effect in women than in men, and a significant age difference with a stronger effect for individuals at high ages. Moreover, we detected a significant interaction between allergy and mood disorder - even an antagonism effect of the two exposures. Allergy increased suicide risk only in persons with no history of mood disorder, whereas it eliminated suicide risk in those with a history of mood disorder. CONCLUSIONS The findings support a link between allergy and suicidality, with a possible mediating role of mood disorder.
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Affiliation(s)
- P Qin
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
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Huber C, Marschallinger J, Tempfer H, Furtner T, Couillard-Despres S, Bauer HC, Rivera FJ, Aigner L. Inhibition of Leukotriene Receptors Boosts Neural Progenitor Proliferation. Cell Physiol Biochem 2011; 28:793-804. [DOI: 10.1159/000335793] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2011] [Indexed: 12/21/2022] Open
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Abstract
BACKGROUND Suicide is a serious public health problem. Prevention of suicide depends to a great degree on identification and mitigation of its risk factors. Allergy has been associated with mood and anxiety disorders, risk factors for suicidality. Antiallergic medication could modulate or mediate these predictive associations. Recently, the FDA issued a warning raising concerns about the suicidality potential of montelukast and other leukotriene (LT) antagonists. OBJECTIVE The purpose of this review is to integrate the emerging interpretations of the link between suicidality, suicide risk factors, allergy and treatment of allergy in particular, with LT antagonists. METHODS We reviewed the available reports on the possible relationships between montelukast, allergy, suicide, suicidality and suicide risk factors. We also present the positions of the FDA, manufacturer, and national organizations of allergists and immunologists on the possible role of montelukast in suicidality. CONCLUSION At present, there is insufficient data to prove that there is a link between montelukast and suicidality. Inquiring about mood changes and suicidal ideation should be integrated in general medical practice.
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Affiliation(s)
- Partam Manalai
- Mood and Anxiety Program, University of Maryland School of Medicine, Department of Psychiatry, 685 West Baltimore Street, MSTF Building Room 930, Baltimore, MD 21201, USA
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Reports of suicidality in clinical trials of montelukast. J Allergy Clin Immunol 2009; 124:691-6.e6. [PMID: 19815114 DOI: 10.1016/j.jaci.2009.08.010] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Revised: 08/11/2009] [Accepted: 08/12/2009] [Indexed: 11/21/2022]
Abstract
BACKGROUND In recent years, a number of drugs and drug classes have come under scrutiny by the US Food and Drug Administration regarding suicidality (including suicidal behavior and ideation). OBJECTIVE We sought to perform 2 reviews (requested by the US Food and Drug Administration) of the number of events possibly related to suicidality reported in Merck clinical trials of montelukast. METHODS Method 1 was a descriptive review of clinical adverse experiences (AEs) from 116 studies (double-blind and open-label, adult and pediatric, and single- and multiple-dose studies) completed as of March 2008. Summaries were constructed from investigator-reported AE terms possibly related to suicidality (completed suicide, suicide attempt, and suicidal ideation) or self-injurious behavior. Method 2 used a retrospective adjudication of investigator-reported AEs and other events listed in the study database described as possibly suicidality-related adverse events (PSRAEs) in a prespecified set of 41 double-blind, placebo-controlled trials completed as of April 2008. RESULTS No completed suicides were reported in any study. For the descriptive review, 20,131 adults and children received montelukast, 9,287 received placebo, and 8,346 received active control; AEs possibly related to suicidality were rare and were similar between the montelukast and placebo or active-control groups. For the adjudicated review across 22,433 patients, there were 730 adjudicated events. In 9,929 patients taking montelukast, 1 PSRAE was identified (classified as suicidal ideation); none were identified in 7,780 and 4,724 patients taking placebo and active control, respectively. CONCLUSIONS Assessed by using 2 complementary methods, there were no reports of completed suicide, and reports of PSRAEs were rare in patients receiving montelukast and similar to those seen in control subjects.
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Benninger MS, Waters H. Montelukast: Pharmacology, Safety, Tolerability and Efficacy. ACTA ACUST UNITED AC 2009. [DOI: 10.4137/cmt.s1147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Allergic rhinitis and asthma are common disorders effecting large percentages of the population of Western countries. There are multiple treatment options available for allergic rhinitis and asthma and stepwise approaches to therapy have been recommended. Montelukast is a cysteinyl leukotriene receptor antagonist that has been found to be effective both in the treatment of allergic rhinitis and asthma. This paper will describe the pharmacology, safety, efficacy and tolerability of montelukast. It will examine the comparative efficacy of montelukast to other medications for the treatment of allergic rhinitis and asthma, as well as discuss the recent studies of combination therapy.
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Affiliation(s)
| | - Heather Waters
- Head and Neck Institute, The Cleveland Clinic, Cleveland, OH, USA
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The role of serotonin and cholesterol in asthma. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33:910-1; author reply 912-3. [PMID: 19348868 DOI: 10.1016/j.pnpbp.2009.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Accepted: 03/28/2009] [Indexed: 11/21/2022]
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