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Su Y, Ye C, Xin Q, Si T. Major depressive disorder with suicidal ideation or behavior in Chinese population: A scoping review of current evidence on disease assessment, burden, treatment and risk factors. J Affect Disord 2023; 340:732-742. [PMID: 37619652 DOI: 10.1016/j.jad.2023.08.106] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/28/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Identifying and managing major depressive disorder (MDD) patients with suicidal ideation or behavior (MDSI) is critical for reducing the disease burden. This scoping review aims to map the existing evidence related to MDSI in the Chinese population. METHOD A scoping review was conducted to summarize the published evidence regarding epidemiology or disease burden, evaluation, diagnosis, management, and prognosis of MDSI. The search strategy imposed restriction on English or Chinese publications between 1 January 2011 and 28 February 2022. RESULTS Of the 14,005 identified records, 133 met the eligibility criteria and were included for analysis. The included studies were characterized as high heterogeneity in evaluation of suicidal ideation or behavior. Compared with MDD patients without suicidal ideation or behavior, MDSI patients were more likely to suffer from psychological and somatic symptoms, social function impairment, and lower quality of life. Younger age, female gender, longer disease course, and comorbid psychological or physical symptoms were consistently found to be risk factors of suicidal ideation or behavior. Relevant research gaps remain regarding comprehensive evaluation of standard clinical diagnosis, disease burden, social-cultural risk factors, and effectiveness of interventions targeting MDSI. Studies with large sample size, representative population are warranted to provide high-quality evidence. CONCLUSIONS MDD patients with suicidal ideation or behavior should be prioritized in treatment and resource allocation. Heterogeneity exists in the definition and evaluation of MDSI in different studies. To better inform clinical practice, it is imperative to establish a unified standard for evaluation and diagnosis of suicidal ideation or behavior among MDD population.
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Affiliation(s)
- Yun'Ai Su
- Peking University Sixth Hospital, Beijing, China; Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Chong Ye
- Xi'an Janssen Pharmaceutical Ltd, Beijing, China
| | - Qin Xin
- Xi'an Janssen Pharmaceutical Ltd, Beijing, China
| | - Tianmei Si
- Peking University Sixth Hospital, Beijing, China; Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
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Shindo R, Tanifuji T, Okazaki S, Otsuka I, Shirai T, Mouri K, Horai T, Hishimoto A. Accelerated epigenetic aging and decreased natural killer cells based on DNA methylation in patients with untreated major depressive disorder. NPJ AGING 2023; 9:19. [PMID: 37673891 PMCID: PMC10482893 DOI: 10.1038/s41514-023-00117-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/29/2023] [Indexed: 09/08/2023]
Abstract
Major depressive disorder (MDD) is known to cause significant disability. Genome-wide DNA methylation (DNAm) profiles can be used to estimate biological aging and as epigenetic clocks. However, information on epigenetic clocks reported in MDD patients is inconsistent. Since antidepressants are likely confounders, we evaluated biological aging using various DNAm-based predictors in patients with MDD who had never received depression medication. A publicly available dataset consisting of whole blood samples from untreated MDD patients (n = 40) and controls (n = 40) was used. We analyzed five epigenetic clocks (HorvathAge, HannumAge, SkinBloodAge, PhenoAge, and GrimAge), DNAm-based telomere length (DNAmTL), and DNAm-based age-related plasma proteins (GrimAge components), as well as DNAm-based white blood cell composition. The results indicate that patients with untreated MDD were significantly associated with epigenetic aging acceleration in HannumAge and GrimAge. Furthermore, a decrease in natural killer cells, based on DNAm, was observed in patients with untreated MDD.
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Affiliation(s)
- Ryota Shindo
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takaki Tanifuji
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoshi Okazaki
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Ikuo Otsuka
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshiyuki Shirai
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kentaro Mouri
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tadasu Horai
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
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Tanifuji T, Okazaki S, Otsuka I, Mouri K, Horai T, Shindo R, Shirai T, Hishimoto A. Epigenetic clock analysis reveals increased plasma cystatin C levels based on DNA methylation in major depressive disorder. Psychiatry Res 2023; 322:115103. [PMID: 36803907 DOI: 10.1016/j.psychres.2023.115103] [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: 11/14/2022] [Revised: 01/01/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023]
Abstract
Major depressive disorder (MDD) is a common mental illness and a major public health concern worldwide. Depression is associated with epigenetic changes that regulate gene expression, and analyzing these changes may help elucidate the pathophysiology of MDD. Genome-wide DNA methylation (DNAm) profiles can function as 'epigenetic clocks' that can help estimate biological aging. Here, we assessed biological aging in patients with MDD using various DNAm-based indicators of epigenetic aging. We used a publicly available dataset containing data obtained from the whole blood samples of MDD patients (n = 489) and controls (n = 210). We analyzed five epigenetic clocks (HorvathAge, HannumAge, SkinBloodAge, PhenoAge, and GrimAge) and DNAm-based telomere length (DNAmTL). We also investigated seven DNAm-based age-predictive plasma proteins (including cystatin C) and smoking status, which are components of GrimAge. Following adjustment for confounding factors such as age and sex, patients with MDD showed no significant difference in epigenetic clocks and DNAmTL. However, DNAm-based plasma cystatin C levels were significantly higher in patients with MDD than controls. Our findings revealed specific DNAm changes predicting plasma cystatin C levels in MDD. These findings may help elucidate the pathophysiology of MDD, leading to the development of new biomarkers and medications.
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Affiliation(s)
- Takaki Tanifuji
- Department of Psychiatry, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Satoshi Okazaki
- Department of Psychiatry, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
| | - Ikuo Otsuka
- Department of Psychiatry, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Kentaro Mouri
- Department of Psychiatry, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Tadasu Horai
- Department of Psychiatry, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Ryota Shindo
- Department of Psychiatry, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Toshiyuki Shirai
- Department of Psychiatry, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; Department of Psychiatry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Luo Y, Lai Q, Huang H, Luo J, Miao J, Liao R, Yang Z, Zhang L. Risk factor analysis and nomogram construction for predicting suicidal ideation in patients with cancer. BMC Psychiatry 2022; 22:353. [PMID: 35610595 PMCID: PMC9128228 DOI: 10.1186/s12888-022-03987-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Suicidal ideation in cancer patients is a critical challenge. At present, few studies focus on factors associated with suicidal ideation, and predictive models are still lacking. This study aimed at investigating the risk factors for suicidal ideation among cancer patients, and developed a predictive nomogram to screen high risk cancer patients for early prevention and intervention. METHODS A questionnaire survey was conducted among cancer patients between May 2021 and January 2022. The factors associated with suicidal ideation were used to construct a multivariate logistic regression model, which was visualized as a predictive nomogram to evaluate the risk of suicidal ideation. Areas under the curve, calibration plot, decision curve analysis, and internal and external validation were used to validate the discrimination, calibration and clinical usefulness of the model. RESULTS A total of 820 patients with cancer were recruited for this study and 213 (25.98%) developed suicidal ideation. Levels of demoralization, depression and cancer staging, marital status, residence, medical financial burden, and living condition were influence factors for suicidal ideation. Comparing nomogram with Self-rating Idea of Suicide Scale (SIOSS), the nomogram had a satisfactory discrimination ability with an AUC of 0.859 (95% CI: 0.827-0.890) and 0.818 (95% CI: 0.764-0.873) in the training and validation sets, respectively. The calibration plot and decision curve analysis revealed that this nomogram was in good fitness and could be beneficial in clinical applications. CONCLUSIONS Suicidal ideation is common in cancer patients. Levels of demoralization, depression and cancer staging were independent predictors of suicidal ideation. The nomogram is an effective and simple tool for predictive suicidal ideation in cancer patients.
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Affiliation(s)
- Yuanyuan Luo
- grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515 China
| | - Qianlin Lai
- grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515 China
| | - Hong Huang
- grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515 China
| | - Jiahui Luo
- grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515 China
| | - Jingxia Miao
- grid.416466.70000 0004 1757 959XDepartment of Medical Oncology, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Baiyun District, Guangzhou, 510515 China
| | - Rongrong Liao
- grid.284723.80000 0000 8877 7471First Nursing Unit of Tumor Ward, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, No. 13, Pomegranate Gang Road, Haizhu District, Guangzhou, 510315 China
| | - Zhihui Yang
- School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515, China.
| | - Lili Zhang
- School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515, China.
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