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Sen P, Adewusi D, Blakemore AI, Kumari V. How do lipids influence risk of violence, self-harm and suicidality in people with psychosis? A systematic review. Aust N Z J Psychiatry 2022; 56:451-488. [PMID: 34240626 PMCID: PMC9036157 DOI: 10.1177/00048674211025608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Low cholesterol has been linked with violent and suicidal behaviour in people with schizophrenia. This association, if consistently present, may be a promising biological marker that could assist clinicians in decision making regarding risk and treatment. We conducted a systematic review to assess whether there is a reliable association between lipid profile (total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides) and aggression, self-harm or suicide in people with schizophrenia, and whether effects are similar in males and females. METHOD Relevant databases were searched to identify primary research studies (up to November 2020) that (1) involved adults (some samples also included 16- to 18-year olds) with a confirmed diagnosis of schizophrenia, schizoaffective disorder or psychosis; and (2) included a standardised assessment of verbal aggression, physical aggression against objects, physical aggression against self (including suicide) or others. The search yielded 23 studies eligible for inclusion following a quality appraisal. RESULTS Suicidality was the most commonly assessed subtype of aggression (20 studies). For suicidality, about half the studies, including the study with the largest sample size, found a link with total cholesterol. An association between low total cholesterol and violence towards others was found in six of nine studies that investigated this. The evidence for a link with violence was the strongest for total cholesterol, followed by low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, and the weakest for triglycerides. Only a few studies investigated sex differences and yielded mixed evidence. Studies focussed on self-harm as well as involving females in forensic settings were lacking. CONCLUSION There is encouraging evidence of an association between low total cholesterol and aggression towards others as well as suicidality in schizophrenia. Future studies should systematically explore this association in people with schizophrenia who have a significant history of violence, suicidality and self-harm, both inpatients and community, and also investigate underlying mechanisms.
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Affiliation(s)
- Piyal Sen
- Department of Life Sciences, Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK,GKT School of Medicine, Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | - Danielle Adewusi
- GKT School of Medicine, Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | - Alexandra I Blakemore
- Department of Life Sciences, Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK,Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Veena Kumari
- Department of Life Sciences, Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK,Veena Kumari, Department of Life Sciences, and Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK.
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2
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Mutsuda N, Hamazaki K, Matsumura K, Tsuchida A, Kasamatsu H, Inadera H, Yamazaki S, Ohya Y, Kishi R, Yaegashi N, Hashimoto K, Mori C, Ito S, Yamagata Z, Nakayama T, Iso H, Shima M, Nakamura H, Suganuma N, Kusuhara K, Katoh T. Change in cholesterol level during pregnancy and risk of postpartum depressive symptoms: the Japan Environment and Children's Study (JECS). Acta Psychiatr Scand 2022; 145:268-277. [PMID: 34963018 PMCID: PMC9303962 DOI: 10.1111/acps.13393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/17/2021] [Accepted: 12/18/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Women with postpartum depressive symptoms (PDS) are at higher risk of postpartum depression (PPD) and require further assessment. Emerging evidence indicates a relationship between the total cholesterol (TC) level of blood and PPD but the results are inconsistent. In this study, we investigated the possible association of change in serum TC levels during pregnancy with the risk of PDS in a Japanese population. METHODS We analyzed complete data on questionnaire responses and serum lipid profiles of pregnant women from 12 datasets obtained from the Japan Environment and Children's Study (n = 61,585 to n = 72,406; 103,063 pregnancies in total). TC was measured at 3 time points-during early pregnancy, during mid-late pregnancy, and after delivery-and we calculated changes in TC in 3 ways: by subtracting early pregnancy from mid-late pregnancy, subtracting mid-late pregnancy from delivery, and subtracting early pregnancy from delivery. These 6 factors were used as predictors to estimate the risk of PDS at 1 and 6 months after delivery. RESULTS In multivariable logistic regression analysis, point serum cholesterol level did not predict PDS at any time point except for during mid-late pregnancy in the second quintile, indicating an increased risk at 6 months. As for change in TC levels, subtracting mid-late pregnancy from delivery and early pregnancy from delivery showed significant risk reduction for PDS at 1 month. A significant risk reduction was also found for subtracting early pregnancy from mid-late pregnancy and early pregnancy from delivery at 6 months. CONCLUSIONS Increased cholesterol level during pregnancy is associated with reduced risk of PDS.
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Affiliation(s)
- Norikazu Mutsuda
- Department of Public Health, Faculty of MedicineUniversity of ToyamaToyamaJapan,Department of NeuropsychiatryFaculty of Medicine, University of ToyamaToyamaJapan
| | - Kei Hamazaki
- Department of Public Health, Faculty of MedicineUniversity of ToyamaToyamaJapan,Toyama Regional Center for JECSUniversity of ToyamaToyamaJapan,Present address:
Department of Public HealthGunma University Graduate School of Medicine3‐39‐22 Showa‐machiMaebashiGunma371‐8511Japan
| | - Kenta Matsumura
- Department of Public Health, Faculty of MedicineUniversity of ToyamaToyamaJapan,Toyama Regional Center for JECSUniversity of ToyamaToyamaJapan
| | - Akiko Tsuchida
- Department of Public Health, Faculty of MedicineUniversity of ToyamaToyamaJapan,Toyama Regional Center for JECSUniversity of ToyamaToyamaJapan
| | - Haruka Kasamatsu
- Toyama Regional Center for JECSUniversity of ToyamaToyamaJapan,Present address:
Health and Welfare DepartmentKizuna Child Development Support CenterTakaokaJapan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of MedicineUniversity of ToyamaToyamaJapan,Toyama Regional Center for JECSUniversity of ToyamaToyamaJapan
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Yu Y, Liang HF, Chen J, Li ZB, Han YS, Chen JX, Li JC. Postpartum Depression: Current Status and Possible Identification Using Biomarkers. Front Psychiatry 2021; 12:620371. [PMID: 34211407 PMCID: PMC8240635 DOI: 10.3389/fpsyt.2021.620371] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 05/19/2021] [Indexed: 12/25/2022] Open
Abstract
Postpartum depression (PPD) is a serious health issue that can affect about 15% of the female population within after giving birth. It often conveys significant negative consequences to the offsprings. The symptoms and risk factors are somewhat similar to those found in non-postpartum depression. The main difference resides in the fact that PPD is triggered by postpartum specific factors, including especially biological changes in the hormone levels. Patients are usually diagnosed using a questionnaire onsite or in a clinic. Treatment of PPD often involves psychotherapy and antidepressant medications. In recent years, there have been more researches on the identification of biological markers for PPD. In this review, we will focus on the current research status of PPD, with an emphasis on the recent progress made on the identification of PPD biomarkers.
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Affiliation(s)
- Yi Yu
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Center for Analyses and Measurements, College of Chemical Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Hong-Feng Liang
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China
| | - Jing Chen
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Zhi-Bin Li
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Yu-Shuai Han
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Jia-Xi Chen
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Ji-Cheng Li
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
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Troisi A, Croce Nanni R. Normal cholesterol levels in the immediate postpartum period: A risk factor for depressive and anxiety symptoms? Psychiatry Res 2018; 269:394-398. [PMID: 30173046 DOI: 10.1016/j.psychres.2018.08.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 07/11/2018] [Accepted: 08/24/2018] [Indexed: 11/25/2022]
Abstract
We aimed to ascertain if cholesterol levels within the reference standards for healthy non-pregnant women are a risk factor for depressive and anxiety symptoms in the immediate postpartum period. During the first week after delivery, total cholesterol levels of 120 new mothers were measured and their mood state was assessed with the Profile of Mood States (POMS). Two weeks before delivery, mothers' personal and family history of mood disturbances was assessed with the Maternal History of Mood Disturbances (MHMD) scale. Only 26 (22%) of the new mothers had normal cholesterol levels (≤200 mg/dL). Mothers with normal levels did not differ on psychometric measures from those with high levels. However, in the subgroup of mothers with normal cholesterol, those with lower levels experienced more symptoms of anxiety, depression and fatigue and scored higher on the MHMD scale. In the larger group of mothers with high cholesterol levels, history of mood disturbances and postpartum depressive and anxiety symptoms were not correlated with total cholesterol. Measuring cholesterol levels in the peripartum can be useful to identify a subgroup of women with naturally low cholesterol levels and an increased risk for postpartum depressive and anxiety symptoms.
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Affiliation(s)
- Alfonso Troisi
- Department of Systems Medicine, International Medical School, University of Rome Tor Vergata, Viale Montpellier 1, 00133 Rome, Italy.
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Trujillo J, Vieira MC, Lepsch J, Rebelo F, Poston L, Pasupathy D, Kac G. A systematic review of the associations between maternal nutritional biomarkers and depression and/or anxiety during pregnancy and postpartum. J Affect Disord 2018; 232:185-203. [PMID: 29494902 DOI: 10.1016/j.jad.2018.02.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 02/06/2018] [Accepted: 02/11/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Nutritional requirements need to be met in order to adapt to pre- and postnatal changes. Our aim was to systematically review the evidence of associations between nutritional biomarkers and psychological distress during pregnancy and in the first postnatal year. METHODS MEDLINE, EMBASE, PsycINFO, Scielo, LILACS, clinicaltrials.gov, International Clinical Trials Registry, Cochrane Library, Scopus and Web of Science databases were searched for articles from inception to 4/15/2016. Studies of maternal nutritional biomarkers in blood (fatty acids/micronutrients/amino acids) and associations with psychological distress (depression/anxiety/stress) were included. Two independent reviewers extracted data based on study designs, participants, outcomes, exposures, and association measures. RESULTS Thirty-eight studies were included. A total of 13 studies showed divergent or no associations between serum/plasma/erythrocyte fatty acid concentrations and depression/anxiety during pregnancy and postpartum. Changes in serum cholesterol levels from pregnancy to postpartum showed a significant inverse correlation with depression in one out of three studies. Five out of seven studies found an inverse association between serum vitamin D levels and pre- and postnatal depression. Plasma tryptophan levels were inversely correlated with postnatal depression scores in three out of four studies. We identified that one out of two studies presented no significant association between vitamin B12/folate/ferritin concentrations and depression in postpartum. LIMITATIONS There was higher variability between association measures, time and scales of depression and anxiety assessments. CONCLUSIONS The majority of high-quality studies suggest that lower vitamin D levels may be associated with postpartum depression. However, further evidence is needed for guiding clinical practice on nutritional biomarkers.
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Affiliation(s)
- Janet Trujillo
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Brazil
| | - Matias Costa Vieira
- Division of Women's Health, Women's Health Academic Centre, King's College London, Biomedical Research Centre, King's Health Partners, London, UK
| | - Jaqueline Lepsch
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Brazil
| | - Fernanda Rebelo
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Brazil; Clinical Research Service, National Institute of Cancer, Rio de Janeiro, Brazil
| | - Lucilla Poston
- Division of Women's Health, Women's Health Academic Centre, King's College London, Biomedical Research Centre, King's Health Partners, London, UK
| | - Dharmintra Pasupathy
- Division of Women's Health, Women's Health Academic Centre, King's College London, Biomedical Research Centre, King's Health Partners, London, UK
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Brazil.
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Veerbeek JH, Hermes W, Breimer AY, van Rijn BB, Koenen SV, Mol BW, Franx A, de Groot CJ, Koster MP. Cardiovascular Disease Risk Factors After Early-Onset Preeclampsia, Late-Onset Preeclampsia, and Pregnancy-Induced Hypertension. Hypertension 2015; 65:600-6. [DOI: 10.1161/hypertensionaha.114.04850] [Citation(s) in RCA: 196] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Observational studies have shown an increased lifetime risk of cardiovascular disease (CVD) in women who experienced a hypertensive disorder in pregnancy. This risk is related to the severity of the pregnancy-related hypertensive disease and gestational age at onset. However, it has not been investigated whether these differences in CVD risk factors are already present at postpartum cardiovascular screening. We evaluated postpartum differences in CVD risk factors in 3 subgroups of patients with a history of hypertensive pregnancy. We compared the prevalence of common CVD risk factors postpartum among 448 women with previous early-onset preeclampsia, 76 women with previous late-onset preeclampsia, and 224 women with previous pregnancy-induced hypertension. Women with previous early-onset preeclampsia were compared with women with late-onset preeclampsia and pregnancy-induced hypertension and had significantly higher fasting blood glucose (5.29 versus 4.80 and 4.83 mmol/L), insulin (9.12 versus 6.31 and 6.7 uIU/L), triglycerides (1.32 versus 1.02 and 0.97 mmol/L), and total cholesterol (5.14 versus 4.73 and 4.73 mmol/L). Almost half of the early-onset preeclampsia women had developed hypertension, as opposed to 39% and 25% of women in the pregnancy-induced hypertension and late-onset preeclampsia groups, respectively. Our data show differences in the prevalence of common modifiable CVD risk factors postpartum and suggest that prevention strategies should be stratified according to severity and gestational age of onset for the hypertensive disorders of pregnancy.
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Affiliation(s)
- Jan H.W. Veerbeek
- From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South
| | - Wietske Hermes
- From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South
| | - Anath Y. Breimer
- From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South
| | - Bas B. van Rijn
- From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South
| | - Steven V. Koenen
- From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South
| | - Ben W. Mol
- From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South
| | - Arie Franx
- From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South
| | - Christianne J.M. de Groot
- From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South
| | - Maria P.H. Koster
- From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South
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HDL-cholesterol concentrations are inversely associated with Edinburgh Postnatal Depression Scale scores during pregnancy: results from a Brazilian cohort study. J Psychiatr Res 2014; 58:181-8. [PMID: 25163727 DOI: 10.1016/j.jpsychires.2014.07.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 07/23/2014] [Accepted: 07/24/2014] [Indexed: 11/23/2022]
Abstract
Serum lipids have been associated with depression in the adult population; however, this association during pregnancy remains unclear. The aim of this study was to evaluate the association between serum lipids and depressive symptom scores during pregnancy. A prospective cohort of 238 pregnant women was followed at the 5th-13th, 20th-26th and 30th-36th weeks of gestation. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Serum concentrations (mg/dL) of triglycerides, total cholesterol, and low- and high-density lipoproteins (LDL-c; HDL-c) were the main exposures. Marital status (married/single), physical activity (active or very active/low or very low active), unplanned pregnancy (no/yes), pre-pregnancy BMI (<25/≥ 25 kg/m(2)), generalized anxiety disorder (no/yes) and current suicidal ideation (no/yes) were considered as potential confounders. Analyses were performed using linear mixed-effects models. The results showed that the EPDS mean score (95%CI) decreased with time during pregnancy trimesters [1st: 8.89 (95%CI = 8.28-9.51), 2nd: 7.32 (95%CI = 6.67-7.97) and 3rd: 7.08 (95%CI = 6.41-7.74)]. Suicidal ideation frequency at baseline was 18%. HDL-c concentrations were inversely associated with changes in EPDS score (β = -0.080, 95%CI = -0.157 to -0.002), while low or very low active women (β = 1.288, 95%CI = 0.630-1.946), with single marital status (β = 1.348, 95%CI = 0.163-2.534), unplanned pregnancy (β = 1.922, 95%CI = 0.714-3.131), generalized anxiety disorder (β = 2.139, 95%CI = 0.410-3.868) and current suicidal ideation (β = 1.927, 95%CI = 0.596-3.258) tended to have higher EPDS scores. No relationship was observed between other lipids and EPDS scores. HDL-c concentration was inversely associated with changes in depressive symptom scores during pregnancy after adjusting for socio-economic, demographic, behavioral, nutritional, biochemical and mental health disorders.
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Troisi A. Cholesterol in coronary heart disease and psychiatric disorders: Same or opposite effects on morbidity risk? Neurosci Biobehav Rev 2009; 33:125-32. [DOI: 10.1016/j.neubiorev.2008.09.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2008] [Revised: 09/01/2008] [Accepted: 09/04/2008] [Indexed: 10/21/2022]
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Are cholesterol and depression inversely related? A meta-analysis of the association between two cardiac risk factors. Ann Behav Med 2008; 36:33-43. [PMID: 18787911 DOI: 10.1007/s12160-008-9045-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2007] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Cholesterol and depression are both cardiac risk factors, but the direction and magnitude of the association between these risk factors is unclear. PURPOSE Meta-analytic techniques were used to evaluate the associations among total, high-, and low-density cholesterol (TC, HDL, LDL, respectively) and depression in empirical studies. METHODS PubMed, CINAHL, PsycINFO, and manual search strategies were used to identify descriptive studies reporting associations among TC, HDL, LDL, and depression; 30 reports were found for TC, 16 for HDL, and 11 for LDL. Effect sizes were computed and aggregated in accord with Hedges and Olkin's (Statistical methods for meta-analysis. New York: Academic Press; 1985) procedures. RESULTS Higher TC was associated with lower levels of depression, d = -0.29; this association was substantially larger among medication-free samples (d = -0.51). An inverse, non-significant association was observed between LDL and depression (d = -0.17). High HDL was related to higher levels of depression, especially in women (d = 0.20). CONCLUSIONS TC and depression were inversely related, with the strongest associations in medically naïve samples, which is noteworthy because such samples should involve fewer confounds. One clinical implication is that the lipids of patients treated for depression should be monitored.
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Lusskin SI, Pundiak TM, Habib SM. Perinatal depression: hiding in plain sight. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2007; 52:479-88. [PMID: 17955909 DOI: 10.1177/070674370705200802] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To promote prompt identification and treatment ofperinatal depression and enhance preventive care for women at risk. METHODS Using MEDLINE and PubMed searches, we reviewed the recent research on the origins, course, and consequences of pregnancy-related depression. RESULTS Depressive disorders are more common in pregnancy and postpartum than widely assumed, and there is no predictable protective effect of pregnancy. Relapse rates are high, and the postpartum period represents a time of increased vulnerability to depression. CONCLUSION Early identification and treatment ofperinatal depression will minimize morbidity and mortality for the woman, the child, and the family.
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Affiliation(s)
- Shari I Lusskin
- New York University School of Medicine, New York, New York, USA.
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11
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Grussu P, Nasta MT, Quatraro RM. Serum cholesterol concentration and distress in the initial days after childbirth. Psychiatry Res 2007; 151:159-62. [PMID: 17368562 DOI: 10.1016/j.psychres.2004.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2003] [Revised: 06/25/2004] [Accepted: 07/28/2004] [Indexed: 11/29/2022]
Abstract
The link between mood disorders and cholesterol is characterized by some contradictory data. In particular, it is not clear whether health factors are responsible for lowered cholesterol levels and mood swings. The present study tests the association between serum cholesterol level and psychological distress in women in two different post-delivery hospital settings: rooming-in (RI) and no rooming-in (no-RI). On day 3 after childbirth, 147 RI and 209 no-RI women completed the Kellner Symptom Questionnaire (SQ), which evaluates anxiety, depression, somatic symptoms and hostility. Plasma cholesterol concentration was measured on the same day. There was a significant negative correlation between cholesterol and depressive symptoms in no-RI women, but not in the RI group. However, this correlation is characterized by an extremely small effect size (-0.15). The findings of this study cast further doubt on the hypothesis of a possible association between cholesterol and depression in the general population and in mothers who have just given birth.
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Affiliation(s)
- Pietro Grussu
- National Health Service, Azienda ULSS nr.17 of Este, Consultorio familiare, Via Papa Giovanni XXIII nr.1, I-35043 Monselice (PD), Italy.
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Abstract
Postpartum psychiatric changes can range from maternity blues to psychosis. Causality is still undetermined, but explanations for these disturbances often focus on hormonal changes and dysregulation. Researchers have begun the process of delineating what neurobiological factors may be associated with depressive disorders in pregnancy and the postpartum. This article reviews the current literature on the roles of gonadal and pituitary hormones in the psychopathophysiology of postpartum mood disorders. Other biological factors, such as biogenic amines, neuroactive steroids, cholesterol, and fatty acids, are also discussed. The potential benefits of neuroimaging to aid in understanding neuropsychiatric changes that occur in the context of postpartum depression are also considered.
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Affiliation(s)
- Jessica Zonana
- New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY, USA.
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Newport DJ, Owens MJ, Knight DL, Ragan K, Morgan N, Nemeroff CB, Stowe ZN. Alterations in platelet serotonin transporter binding in women with postpartum onset major depression. J Psychiatr Res 2004; 38:467-73. [PMID: 15380396 DOI: 10.1016/j.jpsychires.2004.01.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2003] [Revised: 01/26/2004] [Accepted: 01/30/2004] [Indexed: 02/08/2023]
Abstract
There is considerable debate as to whether postpartum depression (PPD) is biologically distinct from other depressive syndromes. Although abnormalities in serotonergic neural systems have repeatedly been reported in depression, few such studies have been conducted in PPD. In the present study, platelet serotonin transporter (SERT) binding was assessed using [(3)H]paroxetine in 14 depressed pregnant women, 31 normal healthy pregnant women, 39 depressed postpartum women, and 27 normal healthy postpartum women; all of the subjects were drug-free. Significant differences were detected among the 4 groups with respect to the dissociation constant (Kd) of platelet binding sites for [(3)H]paroxetine with the highest Kd values among those with PPD. The density (Bmax) of platelet binding sites for [(3)H]paroxetine did not differ between the study groups. These data suggest that PPD may be associated with unique alterations in serotonergic function that are specific to the puerperium.
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Affiliation(s)
- D Jeffrey Newport
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1365 Clifton Road NE, Suite B6100, Atlanta, GA 30322, USA
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14
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De Vriese SR, Christophe AB, Maes M. Lowered serum n-3 polyunsaturated fatty acid (PUFA) levels predict the occurrence of postpartum depression: Further evidence that lowered n-PUFAs are related to major depression. Life Sci 2003; 73:3181-7. [PMID: 14561523 DOI: 10.1016/j.lfs.2003.02.001] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Several studies have shown that major depression is accompanied by alterations in serum fatty acid composition, e.g. reduced n-3 fatty acids and an increased 20:4n-6/20:5n-3 ratio in serum. Moreover, pregnancy leads to depletion of maternal serum 22:6n-3 and after delivery maternal serum 22:6n-3 steadily declines further. Therefore, the aim of the present study was to investigate whether the postpartum fatty acid profile of maternal serum phospholipids (PL) and cholesteryl esters (CE) differs in women who develop postpartum depression compared to controls. We compared the fatty acid composition shortly after delivery of 10 women who developed postpartum depression and 38 women who did not. After delivery, 22:6n-3 and the sum of the n-3 fatty acids in PL and CE was significantly lower in the group of mothers who developed a postpartum depression. The ratio of Sigman-6/Sigman-3 fatty acids in PL was, postpartum, significantly higher in the depressed group as compared to the controls. The abnormalities in fatty acid status previously observed in major depression are now also confirmed in postpartum depression. These results indicate that pregnant women who are at risk to develop postpartum depression may benefit from a prophylactic treatment with n-3 PUFAs, such as a combination of 20:5n-3 and 22:6n-3.
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Affiliation(s)
- S R De Vriese
- Department of Internal Medicine, Division of Nutrition, University of Ghent, Ghent, Belgium
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Tammentie T, Tarkka MT, Astedt-Kurki P, Paavilainen E. Sociodemographic factors of families related to postnatal depressive symptoms of mothers. Int J Nurs Pract 2002; 8:240-6. [PMID: 12225350 DOI: 10.1046/j.1440-172x.2002.00373.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Postnatal depression in mothers is commonplace as it affects 10-15% of recent mothers. Postnatal depression is still an under-diagnosed illness and if unidentified, is often left untreated. If left untreated, the depression can have an adverse effect not only on the mother, but also on the child's development and on the well-being of the whole family. The aim of this survey was to investigate the prevalence of postnatal depressive symptoms among Finnish mothers and to ascertain the relationship with sociodemographic factors in mothers. A sample of 1000 families at 2 months postnatal was studied by mailing the Edinburgh Postnatal Depression Scale to mothers and a questionnaire on demographic characteristics to mothers and fathers. The response rate was 39%. The data were examined by means of frequency and percentage distributions. Connections were examined using Spearman correlation coefficient and analysis of variance. In all, 373 mothers and 314 fathers took part in the study. Fifty-five (13%) mothers had depressive symptoms. Results show that the number of pregnancies, deliveries or children, the mode of delivery or the mother's age were not associated with depressive symptoms. However, mothers who had depressive symptoms had fewer years of education, shorter duration of breast-feeding and were more dissatisfied with family life compared with mothers who exhibited no depressive symptomatology. The families of mothers with depressive symptoms had also experienced more problems and changes having a profound impact on the family compared with other mothers.
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Affiliation(s)
- Tarja Tammentie
- Department of Nursing Science, University of Tampere, Jaakonraitti 8, FIN-33720 Tampere, Finland.
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16
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Troisi A, Moles A, Panepuccia L, Lo Russo D, Palla G, Scucchi S. Serum cholesterol levels and mood symptoms in the postpartum period. Psychiatry Res 2002; 109:213-9. [PMID: 11959358 DOI: 10.1016/s0165-1781(02)00020-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
During pregnancy, the total serum cholesterol concentration rises up to 43%, followed by a rapid fall after delivery. Mild depressive symptoms ('postpartum blues') are a common complication of the puerperium and affect 30-85% of women in the early postpartum period. Based on these observations, it has been suggested that the sudden fall in cholesterol levels after delivery could serve as a 'natural model' to test the suggested association between cholesterol and mood. The present study was designed to expand the database concerning the association between cholesterol levels and mood in the postpartum period and to address some methodological problems raised by previous studies. Forty-seven healthy primiparous women were interviewed with a structured clinical interview on two occasions: during late pregnancy (median: day -20 before the expected delivery) and during the early postpartum period (median: day 32 after delivery). On both occasions, serum concentrations of total and HDL cholesterol were measured and mood symptoms were assessed with the state form of Spielberger's State-Trait Anxiety Index (STAI), the state form of the State-Trait Anger Scale (STAS), and the Beck Depression Inventory (BDI). We found significant, albeit moderate, relationships between serum cholesterol levels and mood symptoms in the postpartum period that were not present during late pregnancy. Lower postpartum levels of total cholesterol were associated with symptoms of anxiety (r=-0.30, P=0.04), anger/hostility (r=-0.31, P=0.04), and depression (r=-0.35, P=0.02), and lower postpartum levels of HDL cholesterol were associated with symptoms of anxiety (r=-0.34, P=0.02). This study confirms that the physiological fall in blood lipids in the postpartum period can be a useful model to test the relationship between serum cholesterol levels and mood.
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Affiliation(s)
- Alfonso Troisi
- Department of Neurosciences, University of Rome Tor Vergata, via G.A. Guattani 14, 00161, Rome, Italy.
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Abstract
The aim of this study was to investigate the relationship between cholesterol and mood states in the initial puerperal period. The Profile of Mood States (POMS) was administered to 72 women on the third day after normal pregnancy, uncomplicated vaginal delivery and healthy baby. Plasma cholesterol concentration was measured the same day. Our study indicates that reduced plasma cholesterol concentration is associated with major feelings of fatigue and depressed mood. The implications of these results are discussed.
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Affiliation(s)
- Maria T Nasta
- Institute of Obstetrics and Gynaecology, University of Padua, Padua, Italy
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18
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Goudsmit E. Response to Renckens. J Psychosom Obstet Gynaecol 2001; 22:61-3. [PMID: 11317612 DOI: 10.3109/01674820109049952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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