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Luo S, Mei Z, Fang G, Mu G, Zhang X, Luo S. Effects of mind-body therapies on depression among adolescents: a systematic review and network meta-analysis. Front Public Health 2024; 12:1431062. [PMID: 39050611 PMCID: PMC11266190 DOI: 10.3389/fpubh.2024.1431062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 06/28/2024] [Indexed: 07/27/2024] Open
Abstract
Background Depression poses significant threats to adolescents' health globally. Research has shown the potential of mind-body therapies to alleviate depression, but limited studies have directly compared the therapeutic effects of different types of mind-body therapies on adolescent depression and the optimal therapy remain unclear. Therefore, we conducted a systematic review and network meta-analysis of randomized controlled trials that met the inclusion criteria to explore the effectiveness of different types of mind-body therapies as interventions to improve depression among adolescents, and to identify the most effective interventions. Methods A comprehensive search of databases including PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus up to January 2024 was conducted to assess the impact of mind-body therapies on depression among adolescents. The risk of bias of the included studies was evaluated using Cochrane Review Manager 5.4. STATA 18.0 was used for network meta-analysis. The node-splitting method was used to test the local inconsistency of the network meta-analysis. Funnel plots and the Egger's test were utilized to assess the potential impact of bias in this study. Result This network meta-analysis included 9 randomized controlled trials involving a total of 955 subjects. The results indicated that yoga, dance therapy and Tai Chi were more effective than other mind-body therapies in reducing symptoms of depression among adolescents. Specifically, according to the SUCRA ranking, yoga was rated to be the optimal intervention for adolescents with depression (SCURA: 82.2%), followed by dance therapy (SCURA: 77.5%) and Tai Chi (SCURA: 64.9%). Conclusion This study revealed that mind-body therapies have positive effects on improving depression among adolescents. Yoga may be the most effective intervention among the different types of mind-body therapies. However, due to the small sample size of patients included, the certainty of the results was limited to some extent. Therefore, further investigation is necessary to strengthen the evidence base when more relevant studies become available. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024508774.
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Affiliation(s)
| | | | | | | | | | - Shi Luo
- School of Physical Education, Southwest University, Chongqing, China
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Xu Y, Li R, Hu C, He Y, Zhang X, Jin L. Global, regional, and national incidence trends of depressive disorder, 1990-2019: An age-period-cohort analysis based on the Global Burden of Disease 2019 study. Gen Hosp Psychiatry 2024; 88:51-60. [PMID: 38508076 DOI: 10.1016/j.genhosppsych.2024.03.003] [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: 09/30/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Depressive disorder is a severe global public health problem. It is crucial to evaluate the global incidence trends of depressive disorder. METHODS The incidence data were drawn from the Global Burden of Disease Study (GBD) 2019. Estimates were presented by global and sociodemographic index (SDI) quintiles, and the age-period-cohort (APC) model was used to estimate the incidence trends. RESULTS APC analysis indicated a decline in depressive disorder incidence globally (net drift = -0.24%, 95%CI: -0.29, -0.18), except for an increase in SDI regions (net drift = 0.07, 95%CI:0, 0.14). In high SDI regions, depressive disorder incidence increased among the younger and declined among the elder population, whereas the opposite trend was observed in middle and low-middle SDI regions. The depressive disorder incidence increased significantly among people aged 15 to 24 years after adjusting for age effects, decreased since 2000 after adjusting for period effects and increased rapidly in the birth cohort after 1990 in high SDI by adjusting for cohort effects. CONCLUSION Globally, there was a declining trend of depressive disorder incidence in 1990-2019. Specifically, the incidence was declining globally in younger populations, while increasing in older populations. However, this trend differed depending on the SDI of the region.
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Affiliation(s)
- Yan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Runhong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Chengxiang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Yue He
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Xinyao Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
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Luo J, Tang L, Kong X, Li Y. Global, regional, and national burdens of depressive disorders in adolescents and young adults aged 10-24 years from 1990 to 2019: A trend analysis based on the Global Burden of Disease Study 2019. Asian J Psychiatr 2024; 92:103905. [PMID: 38262303 DOI: 10.1016/j.ajp.2023.103905] [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: 07/31/2023] [Revised: 12/21/2023] [Accepted: 12/31/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Depressive disorders (DD) including dysthymia and major depressive disorder (MDD) are common among adolescents and young adults. However, global trends in DD burden remain unclear. METHODS We analysed data from the Global Burden of Disease 2019 study on incidence, prevalence, disability-adjusted life years (DALYs), and mortality due to DD from 1990 to 2019 at global, regional and national levels. RESULTS Globally, dysthymia incidence increased notably in females, older age groups, and lower-middle income countries from 1990 to 2019. In contrast, MDD incidence decreased slightly over this period except in high-income North America. Females and middle-income countries had the highest dysthymia burden while North America had the highest MDD incidence and DALYs. Oman and Malaysia experienced largest increases in dysthymia and MDD burden respectively. CONCLUSION Despite certain global indicators suggesting a leveling off or decrease, it's clear that depressive disorders continue to be a significant and increasing issue, particularly among women, teenagers, and young adults. Differences between regions and countries indicate that specific interventions aimed at addressing economic inequalities, improving healthcare systems, and taking cultural factors into account could make a real difference in lessening the burden of depressive disorders. More research is needed to understand what's driving these trends so that we can develop better strategies for preventing and managing these conditions.
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Affiliation(s)
- Jianzhang Luo
- Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Lijuan Tang
- Institute of Prevention and Control of Non‑communicable Chronic Diseases, Hebei Province Center for Disease Prevention and Control, Shijiazhuang 050021, China
| | - Xiangjun Kong
- Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Yu Li
- Department of Cardiovascular Surgery, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, China.
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Andersen E, Prim J, Campbell A, Schiller C, Baresich K, Girdler S. Biobehavioral mechanisms underlying testosterone and mood relationships in peripubertal female adolescents. Dev Psychopathol 2023:1-15. [PMID: 37529837 PMCID: PMC10834847 DOI: 10.1017/s0954579423000937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
The pubertal transition is characterized by pronounced sex hormone fluctuation, refinement of affective neural circuitry, and an increased risk of depression in female adolescents. Sex hormones, including testosterone, exert modulatory effects on frontal-limbic brain networks and are associated with emotion dysregulation and depressive symptoms. Weekly changes in hormones predict affective symptoms in peripubertal female adolescents, particularly in the context of stress; however, the biobehavioral mechanisms underlying hormone change and mood relationships during the pubertal transition have yet to be determined and was the objective of the present study. Forty-three peripubertal female adolescents (ages 11-14) collected 8-weekly salivary hormone (estrone, testosterone) samples and mood assessments to evaluate hormone-mood relationships, followed by a biobehavioral testing session with psychosocial stress and EEG. Within-person correlations between weekly hormone changes and corresponding mood were performed to determine individual differences in mood sensitivity to weekly hormone change. Increased frontal theta activity indexing emotion reactivity, reduced cortisol reactivity, and reduced vagal efficiency predicted the strength of the relationship between testosterone and mood. Further, testosterone-sensitivity strength was associated with the enhancement of negative affect following stress testing. Results identify divergent frontal theta and stress responses as potential biobehavioral mechanisms underlying mood sensitivity to peripubertal testosterone fluctuation.
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Affiliation(s)
- Elizabeth Andersen
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Julianna Prim
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Alana Campbell
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Crystal Schiller
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Kayla Baresich
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Susan Girdler
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
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Valkovskaya M, Hassan A, Zartaloudi E, Hussain F, Umar M, Khizar B, Khattak I, Gill SA, Khan SUDA, Dogar IA, Mustafa AB, Ansari MA, Qalb I Hyder S, Ali M, Ilyas N, Channar P, Mughal N, Channa S, Mufti K, Mufti AA, Hussain MI, Shafiq S, Tariq M, Khan MK, Chaudhry ST, Choudhary AR, Ali MN, Ali G, Hussain A, Rehman M, Ahmad N, Farooq S, Naeem F, Nasr T, Lewis G, Knowles JA, Ayub M, Kuchenbaecker K. Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan. Psychiatr Genet 2023; 33:69-78. [PMID: 36538573 PMCID: PMC9997631 DOI: 10.1097/ypg.0000000000000333] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Globally, 80% of the burdenof major depressive disorder (MDD) pertains to low- and middle-income countries. Research into genetic and environmental risk factors has the potential to uncover disease mechanisms that may contribute to better diagnosis and treatment of mental illness, yet has so far been largely limited to participants with European ancestry from high-income countries. The DIVERGE study was established to help overcome this gap and investigate genetic and environmental risk factors for MDD in Pakistan. METHODS DIVERGE aims to enrol 9000 cases and 4000 controls in hospitals across the country. Here, we provide the rationale for DIVERGE, describe the study protocol and characterise the sample using data from the first 500 cases. Exploratory data analysis is performed to describe demographics, socioeconomic status, environmental risk factors, family history of mental illness and psychopathology. RESULTS AND DISCUSSION Many participants had severe depression with 74% of patients who experienced multiple depressive episodes. It was a common practice to seek help for mental health struggles from faith healers and religious leaders. Socioeconomic variables reflected the local context with a large proportion of women not having access to any education and the majority of participants reporting no savings. CONCLUSION DIVERGE is a carefully designed case-control study of MDD in Pakistan that captures diverse risk factors. As the largest genetic study in Pakistan, DIVERGE helps address the severe underrepresentation of people from South Asian countries in genetic as well as psychiatric research.
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Affiliation(s)
| | - Arsalan Hassan
- Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
| | - Eirini Zartaloudi
- Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Fahad Hussain
- Lahore Institute of Research and Development, Lahore
| | - Muhammad Umar
- Lahore Institute of Research and Development, Lahore
| | - Bakht Khizar
- Lahore Institute of Research and Development, Lahore
| | | | | | | | | | - Ali Burhan Mustafa
- Department of Psychiatry and Behavioural Sciences, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan
| | - Moin Ahmed Ansari
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Syed Qalb I Hyder
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Muhammad Ali
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Nilofar Ilyas
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Parveen Channar
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Nazish Mughal
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Sumera Channa
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | | | | | | | | | | | | | | | | | | | - Gohar Ali
- Department of Psychiatry, Saidu Teaching Hospital
| | | | | | - Noman Ahmad
- Punjab Institute of Mental Health (PIMH), Lahore, Pakistan
| | - Saeed Farooq
- School of Medicine, Keele University, Keele
- Innovation Department, Midlands Partnership NHS Foundation Trust, Staffotdshire, UK
| | - Farooq Naeem
- Department of Psychiatry, University of Toronto
- Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tanveer Nasr
- Lahore Institute of Research and Development, Lahore
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
| | - James A. Knowles
- Human Genetics Institute of New Jersey (HGINJ), Rutgers University, New Brunswick, New Jersey, USA
| | - Muhammad Ayub
- Division of Psychiatry, University College London, London, UK
| | - Karoline Kuchenbaecker
- Division of Psychiatry, University College London, London, UK
- UCL Genetics Institute, University College London, London, UK
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Hua Y, Zhao Q, Shen J, Liu Y, Zheng L, Zhang M. Program for education and enrichment of relational skills (PEERS) training for social skills and depressed mood intervention in young adult with depression: Study protocol for a randomized controlled trial. Front Psychiatry 2022; 13:993124. [PMID: 36172511 PMCID: PMC9510920 DOI: 10.3389/fpsyt.2022.993124] [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: 07/13/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Depression is a common psychiatric disorder characterized by persistent low mood, reduced interest, and slowed thinking. Young adults are the main first-onset group for depression in all categories of the population. Program for education and enrichment of relational skills (PEERS) training, a program for the Education and Enrichment of Relational Skills, has been used in Europe and America for people with various types of social disorders with good results. A Chinese adaptation of the PEERS training program may be a new approach to help youth with depression return to society as soon as possible. This study aimed to construct and optimize a social skills training program for Chinese young adults with depression and to validate the impact of the program. Materials and methods and analysis The aim of this trial protocol is to evaluate the efficacy of the localized PEERS training program on social competence, depressed mood in a Chinese young adult population with depression. The primary outcome will be a change in self-reported depressive symptoms from baseline to week 3 post-randomization to week 6 post-randomization measured using the Liebowitz social anxiety scale (LSAS). Secondary outcomes include the rate of decline in severe social anxiety, the Social Avoidance and Distress Scale (SAD), the Social Self-Efficacy Scale (PSSE), and the Hamilton Depression Scale (HAMD-17). Data for each assessment will be collected at baseline, week 3 of the trial, and week 6 of the trial. Ethics and dissemination Ethics approval was obtained from the Hospital Ethics Committee. Findings will be disseminated through scientific journals, conferences, and university courses. Trial registration number [http://www.chictr.org.cn/], identifier [ChiCTR2100046050].
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Anzolin AP, Feiten JG, Bristot G, Possebon GMP, Fleck MPDA, Caldieraro MA, Kauer-Sant'Anna M. Earlier age of onset is associated with a pro-inflammatory state in major depressive disorder. Psychiatry Res 2022; 314:114601. [PMID: 35749859 DOI: 10.1016/j.psychres.2022.114601] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/29/2022] [Accepted: 05/01/2022] [Indexed: 10/18/2022]
Abstract
Major depressive disorder (MDD) is a common condition that affects the general population over a wide range of ages, regardless of gender and social background. Early-onset of MDD in adulthood, between ages of 18 and 30 years, is associated with worse outcomes and increased years of disability. Stress load and physical health have been associated with age of onset in MDD. We aim to investigate whether early onset MDD might be associated with changes in systemic inflammatory markers. We examined levels of following cytokines: IL-1β, IL-6, IL-10 and TNFα in 234 patients with MDD. Higher serum levels of TNFα and IL-1β are associated with the early onset of the disorder in patients with MDD. IL-6 levels were also higher in the early onset group and IL-10 levels were higher in the late onset group, but with no significant difference. Changes in the anti-inflammatory/pro-inflammatory balance have been described in mood disorders and may be implicated in its severity and pattern of progression. Our findings reinforce that higher serum levels of IL-1β and TNFα may be associated with the earlier onset subgroup of MDD patients. Future research that target inflammatory markers of immune modulation may be, key in the search for novel preventative therapeutics.
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Affiliation(s)
- Ana Paula Anzolin
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; National Institute for Science and Technology in Translational Medicine (INCT-TM), CNPq, FAPESP, CAPES, Brazil.
| | - Jacson Gabriel Feiten
- Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Giovana Bristot
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil
| | - Gabriela Maria Pereira Possebon
- Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil
| | - Marcelo Pio de Almeida Fleck
- Department of Psychiatry and Legal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marco Antonio Caldieraro
- Department of Psychiatry and Legal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; National Institute for Science and Technology in Translational Medicine (INCT-TM), CNPq, FAPESP, CAPES, Brazil
| | - Marcia Kauer-Sant'Anna
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Department of Psychiatry and Legal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; National Institute for Science and Technology in Translational Medicine (INCT-TM), CNPq, FAPESP, CAPES, Brazil.
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Wang M, Yin D, Liu L, Zhou S, Liu Q, Tian H, Wei J, Zhang K, Wang G, Chen Q, Zhu G, Wang X, Si T, Yu X, Lv X, Zhang N. Features of cognitive impairment and related risk factors in patients with major depressive disorder: A case-control study. J Affect Disord 2022; 307:29-36. [PMID: 35358550 DOI: 10.1016/j.jad.2022.03.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cognitive impairment (CI) is a common symptom contributing to functional loss in major depressive disorder (MDD). However, the features of CI and its related risk factors in young and middle-aged MDD patients remain unclear. METHODS In this case-control study, 18- to 55-year-old acute-onset MDD patients and healthy controls (HCs) were recruited from nine centers in China. MDD patients were diagnosed based on the DSM-IV, the Mini-International Neuropsychiatric Interview, and a 17-item Hamilton Rating Scale for Depression score ≥ 14. Cognitive function, including attention/vigilance, learning, memory, processing speed and executive function, was assessed with a neuropsychological battery and compared between MDD patients and HCs. MDD patients scoring 1.5 SDs below the mean HC score in at least 2 domains were defined as having CI. Logistic regression analysis was used to identify risk factors for CI in MDD patients. RESULTS Compared with HCs (n = 302), MDD patients (n = 631) showed significant impairment in all cognitive domains (P < 0.001); 168 MDD patients (26.6%) had CI. Male sex (OR: 1.712; 95% CI: 1.165-2.514; P < 0.01) was positively correlated with CI; age of first onset (OR: 0.974; 95% CI: 0.957-0.991; P < 0.05) and comorbid anxiety disorders (OR: 0.514; 95% CI: 0.332-0.797; P < 0.01) were negatively correlated with CI. LIMITATIONS Biomarkers and neuroimaging were not used to investigate the possible biological mechanism and neural basis of CI in MDD. CONCLUSIONS CI was prominent in adults with acute-onset MDD; male sex and younger age of first onset were independent risk factors, and comorbid anxiety disorders were a protective factor.
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Affiliation(s)
- Meisheng Wang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Deju Yin
- Department of Neurology, Taizhou People's Hospital, Taizhou, China
| | - Lijun Liu
- Department of Psychological Medicine, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Shuzhe Zhou
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Qi Liu
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Hongjun Tian
- Nankai University Affiliated Anding Hospital, Tianjin Mental Health Center, Tianjin, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Gang Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Qiaoling Chen
- Department of Psychiatry, Dalian Seventh People's Hospital, Dalian, China
| | - Gang Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Liaoning, China
| | - Xueyi Wang
- Department of Psychiatry, The First Hospital of Hebei Medical University, Mental Health Institute of Hebei Medical University, Shijiazhuang, China
| | - Tianmei Si
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xin Yu
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xiaozhen Lv
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China.
| | - Nan Zhang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.
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Zhou J, Zhu T, Zhu X, Galling B, Xiao L. Factors associated with antipsychotic use in non-psychotic depressed patients: results from a clinical multicenter survey. BMC Psychiatry 2022; 22:80. [PMID: 35114977 PMCID: PMC8812172 DOI: 10.1186/s12888-021-03411-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 08/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The combination of antipsychotics is not well studied among non-psychotic major depressive disorder (MDD). This study aims to explore the antipsychotics use in this population and its associated factors. METHODS This cross-sectional and multi-site study was conducted in 11 sites of China. one Thousand five hundred three eligible MDD patients after 8-12 weeks of antidepressant treatment were included consecutively. A structured questionnaire was used to obtain socio-demographic data and medical histories. The Chinese version of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR), the Patient Health Questionnaire-15 (PHQ-15) and the Sheehan Disability Scale (SDS) were used for patient self-rating. Logistic regression model was used to explore the associated factors that could potentially be influential for the use antipsychotic augmentation. RESULTS Overall, quetiapine (43.4%) was the most commonly used as an adjunct to antidepressants, followed by olanzapine (38.8%). And antipsychotics were commonly combined with escitalopram (23.1%), venlafaxine (21.7%), sertraline (14.8%). The factors influencing the combination of antipsychotics in non-psychotic depressed patients included service setting (OR = 0.444; p < 0.001; 95%CI = 0.338-0.583), comorbidity of physical illness (OR = 1.704; p < 0.001; 95%CI = 1.274-2.278), PHQ level (OR = 0.680; p < 0.001; 95%CI = 0.548-0.844), SDS level (OR = 1.627; p < 0.001; 95%CI = 1.371-1.930) and antidepressants co-treatment (OR = 2.606; p < 0.001; 95%CI = 1.949-3.485). CONCLUSIONS Antipsychotics use is common among non-psychotic MDD patient. Service setting, comorbidity of physical illness, somatic symptoms, social functioning and engagement, and antidepressants co-treatment could be the factors associated with the antipsychotics use in MDD patients.
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Affiliation(s)
- Jingjing Zhou
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088 China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Tong Zhu
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088 China
| | - Xuequan Zhu
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088 China
| | - Britta Galling
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, School of Medicine, Kiel, Germany ,grid.6363.00000 0001 2218 4662Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany ,grid.440279.c0000 0004 0393 823XDepartment of Child and Adolescent Psychosomatic Medicine and Psychotherapy, Altona Children’s Hospital, Hamburg, Germany
| | - Le Xiao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088, China. .,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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Shorey S, Ng ED, Wong CHJ. Global prevalence of depression and elevated depressive symptoms among adolescents: A systematic review and meta-analysis. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:287-305. [PMID: 34569066 DOI: 10.1111/bjc.12333] [Citation(s) in RCA: 277] [Impact Index Per Article: 92.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 08/02/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Adolescence is a formative and turbulent phase where physiological, psychosocial, and cognitive changes leave adolescents vulnerable to psychological disorders. Given the lack of reviews that consolidate and compare worldwide prevalence of depression among adolescents, this review aims to examine the global prevalence of major depressive disorders, dysthymia, and elevated depressive symptoms among adolescents. METHODS A systematic review and meta-analysis was conducted. Six databases were searched for studies published from 2001 to December 2020. Seventy-two studies were included. Subgroup analysis were performed for year of publication, geographical region, gender, and assessment tools used. RESULTS The global point prevalence rate of elevated self-reported depressive symptoms from 2001 to 2020 was 34% (95% CI: 0.30-0.38). Point prevalence for major depressive disorder (MDD) and dysthymia was 8% (95% CI: 0.02-0.13) and 4% (95% CI: 0.01-0.07), respectively. The pooled one-year prevalence and lifetime prevalence for MDD were 8% (95% CI: 0.05-0.12) and 19% (95% CI: 0.12-0.26). Point prevalence of elevated depressive symptoms among adolescents increased from 24% (95% CI: 0.19-0.28) between 2001 and 2010 to 37% (95% CI: 0.32-0.42) between 2011 and 2020. The Middle East, Africa, and Asia have the highest prevalence of elevated depressive symptoms, and female adolescents were reported to have a higher prevalence of elevated depressive symptoms than male adolescents. CONCLUSION Besides targeting those with existing clinical depression, research and policies should also focus on educational and supportive mitigation efforts to curb depressive symptoms among adolescents before escalation. The findings encourage future research to develop more gender-specific and culturally relevant intervention programmes. PRACTITIONER POINTS 34% of adolescents globally, aged 10-19 years, are at risk of developing clinical depression, which exceeds the reported estimates of individuals aged 18 to 25 years. Practitioners are highly encouraged to prioritize depression screening and intervention implementation for individuals in this age group. Female adolescents and adolescents from Middle East, Africa, and Asia have the highest risk of developing depression. This urges practitioners and researchers to develop more gender-specific and culturally relevant intervention programmes.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Celine H J Wong
- Department of Psychological Medicine, National University Hospital, Singapore
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Early onset of depression and treatment outcome in patients with major depressive disorder. J Psychiatr Res 2021; 139:150-158. [PMID: 34058654 DOI: 10.1016/j.jpsychires.2021.05.048] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/10/2021] [Accepted: 05/18/2021] [Indexed: 11/22/2022]
Abstract
Major depressive disorder (MDD) is a highly heterogeneous disorder, which may partly explain why treatment outcome using antidepressants is unsatisfactory. We investigated the onset of depression as a possible clinical marker for therapy response prediction in the context of somatic biomarkers blood pressure and plasma electrolyte concentration. 889 MDD patients were divided into early (EO, n = 226), intermediate (IO, n = 493), and late onset (LO, n = 169) patients and were analyzed for differences in socio-demographic and clinical parameters, comorbidities and treatment outcome as well as systolic blood pressure and electrolytes. EO patients more often suffered from a recurrent depression, had more previous depressive episodes, a higher rate of comorbid axis I and II disorders, and more often reported of suicidality (p < 0.001) compared to IO and LO patients. Treatment outcome was not different from IO and LO patients, although LO patients responded faster. EO patients who showed an early non-improvement of depression after 2 weeks of therapy (<20% improvement) had a 4.3-fold higher likelihood to become non-remitter as compared to LO patients with an early improvement. EO patients had significantly lower systolic blood pressure than patients with IO or LO and electrolytes in EO patients were significantly correlated with depression severity. Our results confirm other studies showing an association of an early onset of depression with a slower treatment response. The worse treatment outcome in patients with an additional early non-improvement to antidepressant therapy opens perspectives to develop and test individualized treatment approaches for EO and LO patients in the future, which may be based on differences in autonomic regulation.
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Gender differences in quality of life and functional disability for depression outpatients with or without residual symptoms after acute phase treatment in China. J Affect Disord 2017; 219:141-148. [PMID: 28550766 DOI: 10.1016/j.jad.2017.05.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/29/2017] [Accepted: 05/04/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Depression is associated with substantial personal suffering and reduced quality of life and functioning. The aim of this study was to investigate gender differences on quality of life and functional impairment of outpatients with depression after acute phase treatment. METHODS 1503 depression outpatients were recruited from eleven hospitals in China. Subjects were evaluated with sociodemographic characteristics, history and self-report instruments, related to severity of symptoms, function and quality of life. All data were analyzed to determine the gender differences. RESULTS Men had a younger age at onset and the first onset age, higher education compared to women in total patients and with or without residual symptoms group. Using regression analysis, it was found that gender was significantly statistically related to severity scores of SDS and had no correlation with Q-LES-Q-SF total scores. In the residual symptoms group, greater functional impairment was noted by men in the area of work and social life. Significant gender differences of mood, work and sexual life in quality of life were observed. LIMITATIONS This is a cross-sectional study of depressed outpatients and duration of acute phase treatment may not an adequate time to measure changes. CONCLUSIONS Depression appears to affect men more seriously than women after acute phase treatment. Men had a younger age at onset and the first onset age, higher education, more functional impairment and lower satisfaction of quality of life in mood, work and sexual life. Gender differences affect acute treatment, remission and recovery.
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