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Shang Z, Liu N, Ouyang H, Cai X, Yan W, Wang J, Zhan J, Jia Y, Xing C, Huang L, Wu L, Liu W. Sex-based differences in brain morphometry under chronic stress: A pilot MRI study. Heliyon 2024; 10:e30354. [PMID: 38726160 PMCID: PMC11079087 DOI: 10.1016/j.heliyon.2024.e30354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
Background Sex-based differences are known to be a significant feature of chronic stress; however, the morphological mechanisms of the brain underlying these differences remain unclear. The present study aimed to use magnetic resonance imaging (MRI) and voxel-based morphometry (VBM) to investigate the effects of sex on gray matter volume (GMV) changes under conditions of chronic stress. Methods A total of 32 subjects were included for analysis in the present study: 16 participants experiencing chronic stress and 16 healthy controls. T1-weighted (T1WI) images from a 3 T MRI scanner were extracted from the OpenfMRI database. Images were segmented into gray matter using VBM analysis. A two-way analysis of variance (ANOVA) with a 2 × 2 full factorial design was used to evaluate the main and interaction effects of chronic stress and sex on GMV changes, and then post hoc testing was used to verify each simple effect. Results Two-way ANOVA showed a chronic stress × sex interaction effect on GMV. Simple effects analysis indicated that the GMV of the bilateral pre- and post-central gyri, the right cuneus and superior occipital gyrus was decreased in males, whereas that of the bilateral pre- and post-central gyri, the right superior occipital gyrus and the left middle frontal gyrus and orbital middle frontal gyrus was increased in females, under chronic stress. Additionally, in the control group, the GMV of the bilateral pre- and post-central gyri, the right cuneus and superior occipital gyrus was greater in males than females. While in the chronic stress group, the above sex-based differences were no longer significant. Conclusions This study preliminarily shows that there are significant differences in gray matter volume changes between males and females under chronic stress. These findings provide a basis for future studies investigating the volumetric mechanisms of sex differences under chronic stress.
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Affiliation(s)
- Zhilei Shang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Nianqi Liu
- Faculty of Psychology, Institute of Educational Science, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hui Ouyang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Xiaojie Cai
- Department of Radiology, Changshu Hospital Affiliated to Suzhou University, Changshu, 215500, China
| | - Wenjie Yan
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Jing Wang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Jingye Zhan
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Yanpu Jia
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Chenqi Xing
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Lijun Huang
- Department of Radiology, Changshu Hospital Affiliated to Suzhou University, Changshu, 215500, China
| | - Lili Wu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Weizhi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
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Galin S, Keren H. The Predictive Potential of Heart Rate Variability for Depression. Neuroscience 2024; 546:88-103. [PMID: 38513761 DOI: 10.1016/j.neuroscience.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/29/2024] [Accepted: 03/16/2024] [Indexed: 03/23/2024]
Abstract
Heart rate variability (HRV),a measure of the fluctuations in the intervals between consecutive heartbeats, is an indicator of changes in the autonomic nervous system. A chronic reduction in HRV has been repeatedly linked to clinical depression. However, the chronological and mechanistic aspects of this relationship, between the neural, physiological, and psychopathological levels, remain unclear. In this review we present evidence by which changes in HRV might precede the onset of depression. We describe several pathways that can facilitate this relationship. First, we examine a theoretical model of the impact of autonomic imbalance on HRV and its role in contributing to mood dysregulation and depression. We then highlight brain regions that are regulating both HRV and emotion, suggesting these neural regions, and the Insula in particular, as potential mediators of this relationship. We also present additional possible mediating mechanisms involving the immune system and inflammation processes. Lastly, we support this model by showing evidence that modification of HRV with biofeedback leads to an improvement in some symptoms of depression. The possibility that changes in HRV precede the onset of depression is critical to put to the test, not only because it could provide insights into the mechanisms of the illness but also because it may offer a predictive anddiagnosticphysiological marker for depression. Importantly, it could also help to develop new effective clinical interventions for treating depression.
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Affiliation(s)
- Shir Galin
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Gonda Interdisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Hanna Keren
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Gonda Interdisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel.
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3
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Yu H, Yang WM, Chen YH, Guo L, Li R, Xue F, Tan QR, Peng ZW. The gut microbiome from middle-aged women with depression modulates depressive-like behaviors and plasma fatty acid metabolism in female middle-aged mice. J Psychiatr Res 2024; 173:139-150. [PMID: 38531144 DOI: 10.1016/j.jpsychires.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Intestinal dysbacteriosis has frequently been involved in the context of depression. Nonetheless, only scant information is available about the features and functional changes of gut microbiota in female middle-aged depression (MAD). OBJECTIVE This study aims to explore whether there are characteristic changes in the gut microbes of female MAD and whether these changes are associated with depressive-like behaviors. Meanwhile, this study observed alterations in the lipid metabolism function of gut microbes and further examined changes in plasma medium- and long-chain fatty acids (MLCFAs) in mice that underwent fecal microbiota transplantation (FMT). METHODS Stool samples obtained from 31 MAD, along with 24 healthy individuals (HC) were analyzed by 16 S rRNA gene sequencing. Meanwhile, 14-month-old female C57BL/6J mice received antibiotic cocktails and then oral gavage of the microbiota suspension of MAD or HC for 3 weeks to reconstruct gut microbiota. The subsequent depressive-like behaviors, the composition of gut microbiota, as well as MLCFAs in the plasma were evaluated. RESULTS A noteworthy disruption in gut microbial composition in MAD individuals compared to HC was observed. Several distinct bacterial taxa, including Dorea, Butyricicoccus, and Blautia, demonstrated associations with the demographic variables. A particular microbial panel encompassing 49 genera effectively differentiated MAD patients from HC (AUC = 0.82). Fecal microbiome transplantation from MAD subjects led to depressive-like behaviors and dysfunction of plasma MLCFAs in mice. CONCLUSIONS These findings suggest that microbial dysbiosis is linked to the pathogenesis of MAD, and its role may be associated with the regulation of MLCFAs metabolism.
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Affiliation(s)
- Huan Yu
- Department of Psychiatry, Chang'an Hospital, Xi'an, 710000, China; Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China.
| | - Wen-Mao Yang
- Department of Psychiatry, Chang'an Hospital, Xi'an, 710000, China
| | - Yi-Huan Chen
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China
| | - Lin Guo
- Department of Psychiatry, Chang'an Hospital, Xi'an, 710000, China
| | - Rui Li
- Department of Psychiatry, Chang'an Hospital, Xi'an, 710000, China
| | - Fen Xue
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China
| | - Qing-Rong Tan
- Department of Psychiatry, Chang'an Hospital, Xi'an, 710000, China; Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China.
| | - Zheng-Wu Peng
- Department of Psychiatry, Chang'an Hospital, Xi'an, 710000, China; Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China.
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4
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Vasilaki M, Vlachou E, Kavga A, Govina O, Dokoutsidou E, Evangelou E, Ntikoudi A, Mantoudi A, Alikari V. Fatigue among Patients with Type 2 Diabetes Mellitus: The Impact of Spirituality and Illness Perceptions. Healthcare (Basel) 2023; 11:3154. [PMID: 38132044 PMCID: PMC10742637 DOI: 10.3390/healthcare11243154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/30/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
Type 2 Diabetes Mellitus (T2DM) can cause fatigue, negatively affecting the daily functioning and health of individuals. The purpose of this study was to investigate the impact of spirituality and illness perceptions on fatigue among patients with Type 2 Diabetes Mellitus. In this cross-sectional, descriptive study, 100 patients with Type 2 Diabetes Mellitus completed the Fatigue Assessment Scale, the FACIT Sp-12 scale, and the Illness Perception Questionnaire-Revised assessing fatigue, spirituality, and illness perceptions, respectively. The mean age of the sample was 52.18 ± 15.53 years and 65% were insulin-treated patients. The mean score for the FACIT Sp-12 scale was 31.86 ± 7.7, for the FAS 27.0 ± 7.63, and for the Consequences and Emotional Representations of IPQ-R 25.5 ± 5.3. Statistically negative significant correlations were observed between the FACIT Sp-12 total score and the FAS subscales (r = -0.44 to -0.48, p < 0.01) and positive correlations between the "IP-Consequences and Emotional Representations" subscales and FAS scores. The total score of the FACIT Sp-12 (β = -0.35) was a negative predictor while Consequences and Emotional Representations (β = 0.28) were positive predictors of the total FAS Score. Participants scored moderate levels of total fatigue. Spirituality and positive illness perceptions may have a protective effect on the fatigue of patients with Type 2 Diabetes Mellitus.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Victoria Alikari
- Post Graduate Program “Management of Chronic Diseases–Diabetes Nursing Care”, Department of Nursing, University of West Attica, 12243 Egaleo, Greece; (M.V.); (E.V.); (A.K.); (O.G.); (E.D.); (E.E.); (A.N.); (A.M.)
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Wilson JD, Gerlach AR, Karim HT, Aizenstein HJ, Andreescu C. Sex matters: acute functional connectivity changes as markers of remission in late-life depression differ by sex. Mol Psychiatry 2023; 28:5228-5236. [PMID: 37414928 PMCID: PMC10919097 DOI: 10.1038/s41380-023-02158-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 07/08/2023]
Abstract
The efficacy of antidepressant treatment in late-life is modest, a problem magnified by an aging population and increased prevalence of depression. Understanding the neurobiological mechanisms of treatment response in late-life depression (LLD) is imperative. Despite established sex differences in depression and neural circuits, sex differences associated with fMRI markers of antidepressant treatment response are underexplored. In this analysis, we assess the role of sex on the relationship of acute functional connectivity changes with treatment response in LLD. Resting state fMRI scans were collected at baseline and day one of SSRI/SNRI treatment for 80 LLD participants. One-day changes in functional connectivity (differential connectivity) were related to remission status after 12 weeks. Sex differences in differential connectivity profiles that distinguished remitters from non-remitters were assessed. A random forest classifier was used to predict the remission status with models containing various combinations of demographic, clinical, symptomatological, and connectivity measures. Model performance was assessed with area under the curve, and variable importance was assessed with permutation importance. The differential connectivity profile associated with remission status differed significantly by sex. We observed evidence for a difference in one-day connectivity changes between remitters and non-remitters in males but not females. Additionally, prediction of remission was significantly improved in male-only and female-only models over pooled models. Predictions of treatment outcome based on early changes in functional connectivity show marked differences between sexes and should be considered in future MR-based treatment decision-making algorithms.
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Affiliation(s)
- James D Wilson
- Department of Mathematics and Statistics, University of San Francisco, San Francisco, CA, USA
| | - Andrew R Gerlach
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Helmet T Karim
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
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Zheng Z, Zhao W, Zhou Q, Yang Y, Chen S, Hu J, Jiang W, Zhang W, Cai J, Qiu J. Sex differences in depression, anxiety and health-promoting lifestyles among community residents: A network approach. J Affect Disord 2023; 340:369-378. [PMID: 37499917 DOI: 10.1016/j.jad.2023.07.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/14/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Researchers have studied sex differences in typical depressive and anxiety symptoms and their cooccurrence. The World Health Organization (WHO) proposed a mental health promotion objective that suggests considering protective health-promoting factors when developing strategies for preventing mental disorders between sexes. From a network perspective, psychopathology is viewed as a result of interacting symptoms and influential factors. This study adopted network approach to investigate sex differences in health-promoting lifestyles (HPL) and the cooccurrence symptoms of communities in Shanghai. The aim is to provide health-promoting suggestions on better enhancing the life quality for community members. METHODS Depression, anxiety symptoms, and HPL were assessed with PHQ-9, GAD-7 and HPLP-II scales in 2420 adults (1411 females). Networks were constructed by Gaussian Graphical Models and the networks of two sexes using the Network Comparison Test. RESULTS Females scored significantly higher on PHQ-9 (p < 0.001) and GAD-7 (p < 0.001), and no differences were found between the two sexes in HPL scores. Restlessness and low energy yielded the highest strength centrality in the female network, while suicide ideation and restlessness were central in male network. Regarding protective HPL, physical activity and stress management were identified as the central mental health-promoting behaviours in female and male network, respectively. However, stress management was positively related to suicide ideation in the male network. CONCLUSION Communities should be aware of suicide ideation in males because of its high relationships with other symptoms and also provide stress management courses, especially for males. As for women, chronic energy deficiency deserves more attention for its high probability of cooccurrence with other symptoms in the network. Also, advocating physical activities may be particularly beneficial for the overall mental health among women. Future study should collect time-series data and analyze intraindividual networks to specify personalized health promoting strategies for each individual.
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Affiliation(s)
- Ziwei Zheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Wenqing Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Zhou
- Shanghai Xuhui Mental Health Center, Shanghai, China
| | - Yang Yang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuangyi Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Hu
- Shanghai Xuhui Mental Health Center, Shanghai, China
| | - Wenhui Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weibo Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Cai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianyin Qiu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Gabarrell-Pascuet A, Domènech-Abella J, Rod NH, Varga TV. Variations in sociodemographic and health-related factors are linked to distinct clusters of individuals with depression based on the PHQ-9 instrument: NHANES 2007-2018. J Affect Disord 2023; 335:95-104. [PMID: 37156277 DOI: 10.1016/j.jad.2023.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 04/26/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Depression is a heterogeneous disease. Identification of latent depression subgroups and differential associations across these putative groups and sociodemographic and health-related factors might pave the way toward targeted treatment of individuals. METHODS We used model-based clustering to identify relevant subgroups of 2900 individuals with moderate to severe depression (defined as scores ≥10 on the PHQ-9 instrument) from the NHANES cross-sectional survey. We used ANOVA and chi-squared tests to assess associations between cluster membership and sociodemographics, health-related variables, and prescription medication use. RESULTS We identified six latent clusters of individuals, three based on depression severity and three differentially loaded by somatic and mental components of the PHQ-9. The Severe mental depression cluster had the most individuals with low education and income (P < 0.05). We observed differences in the prevalence of numerous health conditions, with the Severe mental depression cluster showing the worst overall physical health. We observed marked differences between the clusters regarding prescription medication use: the Severe mental depression cluster had the highest use of cardiovascular and metabolic agents, while the Uniform severe depression cluster showed the highest use of central nervous system and psychotherapeutic agents. LIMITATIONS Due to the cross-sectional design we cannot make conclusions about causal relationships. We used self-reported data. We did not have access to a replication cohort. CONCLUSIONS We show that socioeconomic factors, somatic diseases, and prescription medication use are differentially associated with distinct and clinically relevant clusters of individuals with moderate to severe depression.
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Affiliation(s)
- Aina Gabarrell-Pascuet
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, Esplugues de Llobregat, Spain; Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Joan Domènech-Abella
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, Esplugues de Llobregat, Spain; Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Naja H Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tibor V Varga
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
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Sun N, Liu M, Liu P, Zhang A, Yang C, Liu Z, Li J, Li G, Wang Y, Zhang K. Abnormal cortical-striatal-thalamic-cortical circuit centered on the thalamus in MDD patients with somatic symptoms: Evidence from the REST-meta-MDD project. J Affect Disord 2023; 323:71-84. [PMID: 36395992 DOI: 10.1016/j.jad.2022.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/21/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Somatic symptoms are common comorbidities of major depressive disorder (MDD), and negatively impact the course and severity of the disease. In order to enrich the understanding of the pathological mechanism and clarify the neurobiological basis of somatic symptoms in depression, we attempted to explore the changes of brain structure and function in a large sample between depression with and without somatic symptoms. METHODS Structure magnetic resonance imaging (MRI) data were collected from 342 patients with somatic symptoms (SD), 208 patients without somatic symptoms (NSD), and 510 healthy controls (HCs) based on the REST-meta-MDD project. We analyzed the whole brain VBM maps of the three groups, and combined with weight degree centrality (DC) index, we investigated whether the brain regions with gray matter volume (GMV) and gray matter density (GMD) abnormalities in MDD patients with somatic symptoms had corresponding brain functional abnormalities. RESULTS Between depression with and without somatic symptoms, we found that there are extensive GMV and GMD differences involving cortical regions such as the temporal lobe, occipital lobe, and insula, as well as subcortical brain regions such as thalamus and striatum. The comparison results of weight DC signals of GMV and GMD abnormal clusters between the SD and NSD groups were basically consistent with the GMV and GMD abnormal clusters. CONCLUSION The results indicate that the structure and function of cortical-striatal-thalamic-cortical (CSTC) circuit centered on the thalamus were abnormal in MDD patients with somatic symptoms. This may be the neurobiological basis of somatic symptoms in MDD.
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Affiliation(s)
- Ning Sun
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China; Department of Mental Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Min Liu
- Department of Psychosomatic, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - Penghong Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Aixia Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Chunxia Yang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Zhifen Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China; Department of Mental Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Jianying Li
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Gaizhi Li
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Yanfang Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China.
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Lawrence TI, Hong JS, Sopchak KS, Voisin DR. The association between exposure to community violence and somatic symptoms through bullying victimization among African American adolescents in Chicago: A developmental trauma approach. J Clin Psychol 2023; 79:1280-1292. [PMID: 36649603 DOI: 10.1002/jclp.23475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/08/2022] [Accepted: 12/17/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND The developmental trauma theory suggests that traumatic events impede the ability of individuals to form interpersonal relationships, impair cognition, affect, and increase the vulnerability of adolescents to develop psychopathology. However, few studies have examined the applicability of this theory among African American adolescents who were exposed to community violence and adverse outcomes, including bullying victimization and somatic symptoms. AIMS Therefore, the purpose of the present study is to first test the association between exposure to community violence and somatic symptoms. Then, we explored whether bullying victimization mediated the relationship between exposure to community violence and somatic symptoms while controlling for gender differences and substance use (n = 622). RESULTS Results suggest that exposure to community violence is positively associated with somatic symptoms. Moreover, the association between exposure to community violence and somatic symptoms was mediated by bullying victimization. DISCUSSION AND CONCLUSION These results were consistent with the developmental trauma theory, such that trauma could increase the vulnerability for future victimization, thus, leading to somatic symptoms. Implications for research and practice are discussed.
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Affiliation(s)
- Timothy I Lawrence
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Texas A&M University, Bryan, Texas, USA
| | - Jun S Hong
- School of Social Work, Wayne State University, Detroit, Michigan, USA.,Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Kelly S Sopchak
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Texas A&M University, Bryan, Texas, USA
| | - Dexter R Voisin
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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Abstract
In this study, it was aimed to evaluate the severity of depression and fatigue in patients with type 2 diabetes mellitus (T2DM), aged ≥ 60 years, with poor diabetes control. Between December 2018 and June 2019, 310 patients aged ≥ 60 years, with hemoglobin A1C ≥ 10%, followed-up with the diagnosis of T2DM for at least 3 years in the internal medicine outpatient clinics of Bursa Yüksek İhtisas Training and research hospital were included in the study. The geriatric depression scale (GDS) and fatigue severity scale (FSS) questionnaires were administered. Patients were analyzed according to their sociodemographic and clinical characteristics, according to their GDS and FSS scores. The GDS and FSS scores were higher in the female patients than in the male patients, those with diabetes aged ≥ 21 years than those aged < 21 years, those using premixed insulin than those using basal bolus insulin and oral antidiabetic drug for + basal insulin, and those living alone than in those living with their families. The FSS score was higher in patients with vitamin D levels < 20 ng/mL. The factors affecting the GDS score were the FGS and FSS scores in the multivariate analysis. The factors affecting the FSS score were the GDS, diabetes age, hemoglobin level, and vitamin D level in the multivariate analysis. Poorly controlled diabetes affects elderly patients more in terms of their mental and physical health. Therefore, these patients should be considered in terms of psychosocial aspects to increase treatment compliance and effects.
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Affiliation(s)
- Irfan Esen
- Yüksek İhtisas Üniversitesi, Faculty of Medicine Department of Internal Medicine, Turkey
| | - Selin Akturk Esen
- Ankara Şehir Hastanesi, Department of Medical Oncology, Turkey
- * Correspondence: Selin Akturk Esen, Ankara Şehir Hastanesi, Department of Medical Oncology, Turkey (e-mail: )
| | - Hakan Demirci
- Bursa Yüksek İhtisas Training and Research Hospital, Department of Family Medicine, Turkey
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Xie T, Wen J, Liu X, Wang J, Poppen PJ. Utilizing network analysis to understand the structure of depression in Chinese adolescents: Replication with three depression scales. Curr Psychol 2022; 42:1-12. [PMID: 35669214 PMCID: PMC9157480 DOI: 10.1007/s12144-022-03201-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 12/15/2022]
Abstract
Depression involves a heterogenous collection of symptoms. Network perspective views depressive symptoms as an interrelated network. The current study aimed to replicate network analyses on adolescent depression in three samples assessed with three instruments to examine the consistency of network structures and also examine the variance of networks between genders. Three samples of adolescents (total N = 4375, mean age = 15, 49.1% boys) were assessed with PHQ-9, SMFQ and CDI, respectively. Network analyses were carried out on depression symptoms. Network stability, node centrality and network comparisons between genders were examined. Three networks were reliably stable. Sadness and self-hatred were unanimously identified to be central symptoms of adolescent depression in three networks. In addition, fatigue, no good, everything wrong and loneliness also appeared to be central in specific networks. Among three depression networks, PHQ-9 network demonstrated gender difference in network structure. The current study is exploratory in nature. The differences in three networks can be due to various samples or different node inclusions. Further, the study is cross-sectional precluding causal interpretation and the samples are nonclinical. Besides "hallmark" symptom sadness, self-hatred was also identified unanimously in three networks, which demonstrated the significant role self-worth played in adolescent depression. The results also suggested that differences in node inclusion may have influence on the network structure. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-03201-z.
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Affiliation(s)
- Tong Xie
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
| | - Jun Wen
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
- Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Xiaoyan Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
| | - Jianping Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
| | - Paul J. Poppen
- Psychological and Brain Sciences, George Washington University, Washington, DC USA
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Rouch I, Edjolo A, Celle S, Pichot V, Laurent B, Borg C, Dorey JM, Roche F. Association between depressive symptoms and long-term heart rate variability in older women: Findings from a population-based cohort. J Affect Disord 2022; 305:151-158. [PMID: 35219741 DOI: 10.1016/j.jad.2022.02.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/17/2022] [Accepted: 02/19/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Cross-sectional studies highlighted changes in autonomic nervous system (ANS) activity in geriatric depression. However, few longitudinal studies assessed this link which remains still debated. We examined the longitudinal association between lifetime depression history, current depressive disorders, and the evolution of ANS activity in older community women. METHODS The present data stemmed from the PROOF study, a population-based cohort of 1011 community-dwellers followed-up at 2-year intervals for 10 years. Only data from female participants was analyzed (n = 508, mean age 68.5 ± 0.88 years), as very few men had depression in our population. Depressive symptoms and depression history were collected at baseline. Participants were classified in four groups according to presence or absence of history of depression (HD) or current depressive symptomatology (CD): HD+/CD+, HD-/CD+, HD+/CD- and HD-/CD-. ANS activity was assessed during the follow-up through 24-h heart rate variability (HRV). Longitudinal associations between depressive status and HRV indices during the follow-up were investigated using multivariate linear mixed models. RESULTS Compared to HD-/CD- group, women belonging to HD-/CD+ group had greater baseline parasympathetic tone, as measured by lower LF index and LF/HF balance. The longitudinal analysis exhibited a significant enhancement of LF/HF balance with time, measuring an increase of sympathetic tone in HD-/CD+ group. CONCLUSION Our findings suggest that late-onset depressive symptoms may be associated with subsequent autonomic dysregulation in older women. These results highlight the importance of detecting and managing depressive symptoms to limit their consequences on ANS functioning, and the risk of cardiovascular events.
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Affiliation(s)
- Isabelle Rouch
- Memory Clinical and Research Center of Saint Etienne (CMRR), Neurology Unit, University Hospital of Saint Etienne, Saint Etienne, France.; INSERM, U1219, Bordeaux Population Health Center, University of Bordeaux, Bordeaux, France.
| | - Arlette Edjolo
- Memory Clinical and Research Center of Saint Etienne (CMRR), Neurology Unit, University Hospital of Saint Etienne, Saint Etienne, France.; INSERM, U1219, Bordeaux Population Health Center, University of Bordeaux, Bordeaux, France
| | - Sébastien Celle
- Clinical Physiology, Visas Center, University Hospital, Saint-Etienne, France.; INSERM SAINBIOSE U1059, DVH, Jean Monnet University, Saint Etienne, France
| | - Vincent Pichot
- Clinical Physiology, Visas Center, University Hospital, Saint-Etienne, France.; INSERM SAINBIOSE U1059, DVH, Jean Monnet University, Saint Etienne, France
| | - Bernard Laurent
- Memory Clinical and Research Center of Saint Etienne (CMRR), Neurology Unit, University Hospital of Saint Etienne, Saint Etienne, France.; INSERM, U1028; CNRS, UMR5292; Neuropain Team, Lyon Neuroscience Research Center, Lyon, F-69000, France
| | - Céline Borg
- Memory Clinical and Research Center of Saint Etienne (CMRR), Neurology Unit, University Hospital of Saint Etienne, Saint Etienne, France
| | | | - Frédéric Roche
- Clinical Physiology, Visas Center, University Hospital, Saint-Etienne, France.; INSERM SAINBIOSE U1059, DVH, Jean Monnet University, Saint Etienne, France
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Grønli OK, Bramness JG, Wynn R, Høye A. Depressive symptoms in the general population: The 7th Tromsø Study. Journal of Affective Disorders Reports 2022. [DOI: 10.1016/j.jadr.2022.100322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Carpenter RK, Alloway TP. Exploring working memory, self-criticism, and rumination as factors related to self-harm. Psychol Rep 2022:332941221074258. [PMID: 35084275 DOI: 10.1177/00332941221074258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prevalence of self-harm and the relative emotional influences are well understood, but certain cognitive factors such as working memory, rumination, and self-criticism are not fully explored. The aim of the current study is to examine specific aspects of cognition to explore their influence on self-harming behaviors. Participants included 101 undergraduates from a British University. Factors were measured using the Centre for Epidemiological Studies Depression Scale, the Depressive Experiences Questionnaire, Ruminative Response Scale, and the Automated Working Memory Assessment. Findings indicated a greater incidence of self-harming behaviors among those who demonstrated higher depressive symptoms, but depression scores were not significantly related to self-harm. Additionally, a binary logistic regression indicated that self-criticism was associated with the presence of self-harming behavior, and a Classification and Regression Trees found that the single strongest predictor of self-harming behavior was a belief that love needs to be continually earned from others. Incorporating treatments that reduce self-criticism, such as improving self-compassion with Compassionate Mind Training, may address underlying mechanisms that trigger self-harm behavior. Keywords: rumination, depression, self-criticism, working memory, self-harm.
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15
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Liu P, Tu H, Zhang A, Yang C, Liu Z, Lei L, Wu P, Sun N, Zhang K. Brain functional alterations in MDD patients with somatic symptoms: A resting-state fMRI study. J Affect Disord 2021; 295:788-796. [PMID: 34517253 DOI: 10.1016/j.jad.2021.08.143] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/22/2021] [Accepted: 08/27/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE It has been established that major depressive disorder (MDD) is accompanied by various somatic symptoms that are related to the clinical course and severity of depression. However, the mechanisms of somatic symptoms in MDD have rarely been studied. In this study, we sought to investigate the functional neurological changes in MDD patients with somatic symptoms based off the regional homogeneity (ReHo) and the amplitude of low-frequency fluctuation (ALFF). METHOD Study participants included 74 first-episode, drug naïve MDD patients as well as 70 healthy subjects (HCs). Patients diagnosed with MDD were separated into two groups based on the presence (n=50) or absence (n=24) of somatic symptoms. Functional images were obtained and analyzed. Alterations in ReHo/ALFF and the severity of clinical symptoms were investigated using correlation analysis. RESULTS More severe depressive symptoms were observed in the somatic depression group than that of the pure depression group (P< 0.001). Furthermore, there was a significant reduction in ReHo and ALFF in the bilateral precentral gyrus, bilateral postcentral gyrus, and left paracentral gyrus in the somatic MDD group as compared to the pure depression group (GRF correction, voxel-P< 0.001, cluster-P < 0.01). Pearson correlation analysis revealed a negative correlation between ReHo and ALFF values in these abnomal regions with the severity of somatic and depressive symptoms (P< 0.01). CONCLUSION Somatic depression is more severe than pure depression. The ReHo and ALFF changes in the precentral gyrus, postcentral gyrus, and paracentral gyrus may serve a significant role in the pathophysiology of somatic symptoms in MDD.
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Affiliation(s)
- Penghong Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China; Shanxi Medical University, Taiyuan 030001, PR China
| | - Hongwei Tu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China; Shanxi Medical University, Taiyuan 030001, PR China
| | - Aixia Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China
| | - Chunxia Yang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China
| | - Zhifen Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China
| | - Lei Lei
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China; Department of Psychiatry, Second Hospital of Shanxi Medical University, Taiyuan 030001, PR China
| | - Peiyi Wu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China; Shanxi Medical University, Taiyuan 030001, PR China
| | - Ning Sun
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China.
| | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China.
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16
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Ren Q, Li Y, Chen DG. Measurement invariance of the Kessler Psychological Distress Scale (K10) among children of Chinese rural-to-urban migrant workers. Brain Behav 2021; 11:e2417. [PMID: 34775684 PMCID: PMC8671765 DOI: 10.1002/brb3.2417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Kessler Psychological Distress Scale (K10) is a 10-item screening tool designed for nonspecific psychological distress. The current study aims to identify a best-fitting factor structure of the K10, and to test its cross-gender measurement invariance based on the structure. METHODS Using convenience sampling, we included 339 (n = 192 for boys and 135 for girls) children of Chinese rural-to-urban migrant workers in Hangzhou, China. RESULTS Confirmatory factor analysis for ordered-categorical measures revealed a two-factor structure as the best-fitting model, in which five items (hopeless, depressed, effort, severely depressed, and worthless) loaded on depression and the other five items loaded on anxiety (tired, nervous, severely nervous, restless, and severely restless). The model held at different levels of the measurement invariance testing, that is, full measurement invariance was not rejected in our sample, suggesting that gender differences as assessed with K10 reflect true differences. Structural invariance testing showed that girls in our sample showed significantly higher levels of depression and anxiety than boys. CONCLUSION These findings support that the K10 is suitable for gender-comparative research among children of Chinese migrant workers. Using the K10 as a screening tool among this population should be promoted. Limitations and directions for future research were discussed.
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Affiliation(s)
- Qiang Ren
- Department of Sociology, Zhejiang University, 866 Yuhangtang Rd, Hangzhou, Zhejiang, 310027, China
| | - Yong Li
- Department of Social Work, California State University Bakersfield, 9001 Stockdale Hwy, Bakersfield, California, 93311, USA
| | - Ding-Geng Chen
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, Arizona, 85004, USA
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Abstract
OBJECTIVE To study the features of psychopatological structure of endogenous depression in young women and to identify correlations between various clinical types of depression and their nosological affilation. MATERIAL AND METHODS The results of clinical/psychopathological examination of 107 female patients, aged 16 to 25 years, with endogenous depression with one of the following ICD-10 diagnosis: (F34.0; F31.3-F31.5; F21.3-F.21.4+F31.3-F31.5; F60.X+F31.3-F31.5) were analyzed. RESULTS Several types of endogenous depression were identified: 1) hysterical depression with hysterical-conversions, and also the phenomena of delusional fantasies; 2) dysmorphic depression with predominance of over-valued ideas of physical disability, self-inferiority and eating disorder; 3) depersonalization depression with depersonalization-derealization symptoms; 4) psychopath-like depression with exaggerated behavior, opposition and impulsivity; 5) existential depression with a feeling of losing the life meaning and often pessimistic worldview; 6) psychasthenic depression with the low self-esteem and exaggerated introspection combined with obsessive-phobic disorder; 7) anxious-melancholic depression with anxiety, melancholy and ideas of self-accusation and self-inferiority; 8) depression with symptoms of adolescent asthenic insolvency with difficulties of understanding information, increasing intellectual exhaustion. We revealed differences in motives for committing non-suicidal self-harm behavior and suicidal behavior in typological variants of depressions. CONCLUSION Hysteroform and psychopathic depressions prevail in personality disorders, while psychosthenic-like, anxious-melancholic and existential depressions are more frequent in affective disorders. Depersonalization depressions are more common in schizotypal disorder. When comparing the types of depressions in boys as reported in previous research with those in girls, the prevalence of hysteroform and anxious-melancholic variants in girls is revealed.
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18
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Abstract
Women are twice as likely to experience depression than men, yet until recently, preclinical studies in rodents have focused almost exclusively on males. As interest in sex differences and sex-specific mechanisms of stress susceptibility increases, chronic stress models for inducing depression-relevant behavioral and physiological changes in male rodents are being applied to females, and several new models have emerged to include both males and females, yet not all models have been systematically validated in females. An increasing number of researchers seek to include female rodents in their experimental designs, asking the question "what is the ideal chronic stress model for depression in females?" We review criteria for assessing female model validity in light of key research questions and the fundamental distinction between studying sex differences and studying both sexes. In overviewing current models, we explore challenges inherent to establishing an ideal female chronic stress model, with particular emphasis on the need for standardization and adoption of validated behavioral tests sensitive to stress effects in females. Taken together, these considerations will empower female chronic stress models to provide a better understanding of stress susceptibility and allow the development of efficient sex-specific treatments.
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Affiliation(s)
- Joëlle Lopez
- Department of Psychology, McGill University, Montréal, Quebec, Canada
| | - Rosemary C Bagot
- Department of Psychology, McGill University, Montréal, Quebec, Canada; Ludmer Centre for Neuroinformatics and Mental Health, Montréal, Quebec, Canada.
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19
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Abelaira HM, Veron DC, de Moura AB, Carlessi AS, Borba LA, Botelho MEM, Andrade NM, Martinello NS, Zabot GC, Joaquim L, Biehl E, Bonfante S, Budni J, Petronilho F, Quevedo J, Réus GZ. Sex differences on the behavior and oxidative stress after ketamine treatment in adult rats subjected to early life stress. Brain Res Bull 2021; 172:129-138. [PMID: 33932489 PMCID: PMC10464594 DOI: 10.1016/j.brainresbull.2021.04.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 01/22/2023]
Abstract
This study aimed to evaluate the effects of ketamine, on behavioral parameters, oxidative stress, and inflammation in the brain of male and female rats submitted to the animal model of maternal deprivation (MD). Wistar rats were deprived of maternal care in the first 10 days of life (three hours daily). As adults, male and female rats were divided: control + saline deprived + saline and deprived + ketamine (15 mg/kg). The behavior was evaluated through the open field and forced swimming tests. Then brain was removed for analysis of oxidative damage, the activity of superoxide dismutase (SOD), catalase (CAT), and myeloperoxidase (MPO) activity, and levels of interleukin-6 (IL-6). MD induced depressive behavior in males and ketamine reversed these changes. MD induced an increase in lipid peroxidation in males and females; ketamine reversed these effects in males. Protein carbonylation was increased in males and females, with ketamine decreasing such effects. The concentration of nitrite/nitrate increased in males and females, whereas ketamine decreased this in the PFC of males. SOD and CAT activities were decreased in male and female deprived groups and deprived groups treated with ketamine. MPO activity and IL-6 levels increased in males subjected to MD and ketamine reversed this effect. The results suggest that stressful events in early life can induce behavioral, neuroimmune changes, and oxidative stress, however, such effects depend on sex and brain area. Ketamine presents anti-inflammatory and antioxidant properties and could be considered an alternative for individuals who are resistant to classical treatments.
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Affiliation(s)
- Helena M Abelaira
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Deise Cristina Veron
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Airam B de Moura
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Anelise S Carlessi
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Laura A Borba
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Maria Eduarda M Botelho
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Natalia M Andrade
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Nicolly S Martinello
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Gabriel C Zabot
- Experimental Neurology Laboratory, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciúma, SC, Brazil
| | - Larissa Joaquim
- Laboratory of Clinical and Experimental Pathophysiology, Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Tubarão, SC, Brazil
| | - Erica Biehl
- Laboratory of Clinical and Experimental Pathophysiology, Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Tubarão, SC, Brazil
| | - Sandra Bonfante
- Laboratory of Clinical and Experimental Pathophysiology, Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Tubarão, SC, Brazil
| | - Josiane Budni
- Experimental Neurology Laboratory, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciúma, SC, Brazil
| | - Fabricia Petronilho
- Laboratory of Clinical and Experimental Pathophysiology, Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Tubarão, SC, Brazil
| | - João Quevedo
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil; Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA; Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Gislaine Z Réus
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.
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Wang X, Shen K. The Reciprocal Relationship between Frailty and Depressive Symptoms among Older Adults in Rural China: A Cross-Lag Analysis. Healthcare (Basel) 2021; 9:healthcare9050593. [PMID: 34067906 PMCID: PMC8156888 DOI: 10.3390/healthcare9050593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/01/2021] [Accepted: 05/13/2021] [Indexed: 12/02/2022] Open
Abstract
(1) Objective: This study aimed to investigate the reciprocal relationship between frailty and depressive symptoms using longitudinal data among older adults in China. (2) Methods: Data derived from 2014 and 2017 waves of a longitudinal study of 1367 older adults aged 70–84 years, living in rural areas of Jiangsu Province, China. Cross-lagged panel model and a multiple group model were used to examine the temporal effect of frailty on depressive symptoms and vice versa. (3) Results: Frailty was associated with subsequent increase in depressive symptoms, such that participants with higher levels of frailty increase the risks of depressive symptoms (b = 0.090, p < 0.01). Depressive symptoms were significant predictors of increased frailty (b = −0.262, p <0.001). However, older men and older women had no significant differences in the reciprocal relationship between frailty and depressive symptoms. (4) Conclusions: In conclusion, we find a significant bi-directional relationship between frailty and depressive symptoms. This finding confirms the dyadic model of frailty and depression. Implications for interventions and policy to help frail and depressive older adults are discussed.
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Affiliation(s)
- Xuehui Wang
- Center for Population and Development Policy Studies, School of Social Development and Public Policy, Fudan University, Shanghai 200433, China;
| | - Kaijun Shen
- School of Social Development and Public Policy, Fudan University, Shanghai 200433, China
- Correspondence:
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21
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Vetter JS, Spiller TR, Cathomas F, Robinaugh D, Brühl A, Boeker H, Seifritz E, Kleim B. Sex differences in depressive symptoms and their networks in a treatment-seeking population - a cross-sectional study. J Affect Disord 2021; 278:357-364. [PMID: 33002727 PMCID: PMC8086368 DOI: 10.1016/j.jad.2020.08.074] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 07/20/2020] [Accepted: 08/25/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The higher prevalence of major depressive disorder (MDD) in females relative to males is well-established. Some authors have posited this difference arises to divergent symptom profiles in females vs. males. However, empirical tests of this hypothesis have yielded equivocal results. Here, we investigate sex differences in MDD of individual symptoms and symptom networks in a treatment-seeking sample. METHODS We assessed depressive symptoms using Hamilton Depression Rating Scale (HDRS-17) in 590 treatment-seeking adults with MDD (300 females). We examined group differences in symptom endorsement. We investigated symptom networks and estimated Gaussian Graphical Models. Finally, we compared the female and male networks using the Network Comparison Test. RESULTS Females scored significantly higher in psychological anxiety (p <0.001; rB = -0.155), somatic anxiety (p = .001; rB = -0.150) and feelings of guilt (p = .002; rB = -0.139). Male and female patients did not differ in depression sum scores. There were no sex differences in network structure or global strength. LIMITATIONS Our study was sufficiently powered to detect only medium sized symptom differences. The generalizability of our study is limited to clinical samples and further studies are needed to investigate if findings also translate to outpatient samples. CONCLUSION Females reported elevated anxiety symptoms and guilt. Clinicians should assess these symptom differences and tailor treatment to individual symptom profiles. No differences between sexes emerged in MDD network structures, indicating that features may be more similar than previously assumed. Sex differences in psychopathological features of MDD are important for future research and personalized treatment.
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Affiliation(s)
- Johannes Simon Vetter
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - Tobias Raphael Spiller
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Flurin Cathomas
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Department of Neuroscience, Centre for Affective Neuroscience, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States
| | - Donald Robinaugh
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Annette Brühl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Heinz Boeker
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Birgit Kleim
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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22
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Shi P, Yang A, Zhao Q, Chen Z, Ren X, Dai Q. A Hypothesis of Gender Differences in Self-Reporting Symptom of Depression: Implications to Solve Under-Diagnosis and Under-Treatment of Depression in Males. Front Psychiatry 2021; 12:589687. [PMID: 34759845 PMCID: PMC8572815 DOI: 10.3389/fpsyt.2021.589687] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/23/2021] [Indexed: 11/13/2022] Open
Abstract
The phenomenon of female preponderance in depression has been well-reported, which has been challenged by higher rates of suicide and addictive behaviors in males, and a longer life-span in females. We thus propose an alternative hypothesis "Gender differences in self-reporting symptom of depression," suggesting mild-moderate depression tends to be reported more often by females, and severe depression and suicide tend to be reported more often by males. Potential mechanisms that account for this difference may include three aspects: covariation between estrogen levels and the incidence peak of female depression, gender differences in coping style (e.g., comparative emotional inexpressiveness and non-help-seeking in males), and gender differences in symptom phenotypes (e.g., atypical symptoms in male depression). Our newly presented hypothesis implied the overlooked under-diagnosis and under-treatment of depression in males. For effective diagnoses and timely treatment of male depression, it is critical to incorporate symptoms of depression in males into the relevant diagnostic criteria, encourage males to express negative emotions, and increase awareness of suicidal behavior in males.
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Affiliation(s)
- Peixia Shi
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Aigang Yang
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Qing Zhao
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhaohua Chen
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Xiaomei Ren
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Qin Dai
- Department of Nursing Psychology, Army Medical University, Chongqing, China
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McNealy KR, Lombardero A. Somatic presentation of mental health concerns, stigma, and mental health treatment engagement among college students. J Am Coll Health 2020; 68:774-781. [PMID: 30973799 DOI: 10.1080/07448481.2019.1590372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/19/2018] [Accepted: 02/24/2019] [Indexed: 06/09/2023]
Abstract
Objective: To identify mental health and treatment utilization correlates of somatic symptoms.Participants: Undergraduate students (N = 184) were recruited through an online research portal from November 2017 to May 2018. Methods: Cross-sectional survey. Results: Somatic symptoms were significantly correlated with public stigma, depression, and anxiety. Controlling for demographics, somatic symptoms, depression scores, and belief in the effectiveness of therapy emerged as concurrent predictors of mental health treatment use in logistic regression analyses. Conclusions: Given the detrimental effects of somatic symptoms on health outcomes and academic performance, universal screening of somatic and psychiatric symptoms in primary care and mental health settings serving college students is warranted. Future research should differentiate between patients who experience somatic versus affective symptoms of depression. In addition, researchers should examine the degree to which addressing the relationship between somatic and psychological symptoms can help lessen the added burden of somatic symptoms on individuals' functioning.
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Affiliation(s)
- Kathleen R McNealy
- Department of Psychology, University of Alaska Anchorage, Anchorage, AK, USA
| | - Anayansi Lombardero
- Department of Psychology, University of Alaska Anchorage, Anchorage, AK, USA
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24
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Vikjord SAA, Brumpton BM, Mai X, Vanfleteren L, Langhammer A. The association of anxiety and depression with mortality in a COPD cohort. The HUNT study, Norway. Respir Med 2020; 171:106089. [DOI: 10.1016/j.rmed.2020.106089] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 07/05/2020] [Accepted: 07/10/2020] [Indexed: 02/07/2023]
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25
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Tobaldini E, Carandina A, Toschi-Dias E, Erba L, Furlan L, Sgoifo A, Montano N. Depression and cardiovascular autonomic control: a matter of vagus and sex paradox. Neurosci Biobehav Rev 2020; 116:154-161. [DOI: 10.1016/j.neubiorev.2020.06.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/13/2020] [Accepted: 06/24/2020] [Indexed: 12/13/2022]
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26
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Qi L, Zhang Y, Wang L, Wang R, Wu J, Zhou X, Chen J, Zhang S, Zhou Y, Zhang XY. Sex differences in psychotic and non-psychotic major depressive disorder in a Chinese Han population. J Affect Disord 2020; 268:55-60. [PMID: 32158007 DOI: 10.1016/j.jad.2020.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 01/15/2020] [Accepted: 03/02/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sex differences between psychotic depression (PD) and non-psychotic depression (NPD) have received little systematic study. This study was conducted to investigate sex difference in patients with psychotic and non-psychotic major depressive disorder in a Chinese Han population. METHODS In this cross-sectional study, a total of 1718 first-episode and drug-naïve outpatients with major depressive disorder were recruited. Demographic and clinical characteristics were collected. All subjects were rated on the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and the Positive and Negative Syndrome Scale (PANSS). RESULTS The prevalence of PD in female patients (10.97%) was higher than that in male patients (7.99%). Analysis of variance (ANOVA) showed that female patients were older compared with male patients in NPD group, but there were no significant differences in demographic and clinical variables between female and male PD patients. Further, there were no sex differences in the scores of HAMD, HAMA and positive symptom subscale of PANSS in both PD and NPD groups. Two-way ANOVA showed that PD patients had significantly higher scores on the HAMD, HAMA and positive symptom subscale of PANSS than non-PD patients. However, there were no significant effects of sex and sex* subtypes. LIMITATIONS The main limitations are cross-sectional design and inability to control selection bias. CONCLUSIONS Our findings show significant differences in clinical profiles between PD and NPD patients; however, no sex difference has been observed in the either PD or NPD patients.
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Affiliation(s)
- Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Yaping Zhang
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Affiliated Wuhan Mental Health Center,Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Liewei Wang
- Wuhan Xinzhou District Mental Health Center, Wuhan, China
| | - Ruoxi Wang
- School of Medicine and Health Management,Tongji Medical College of Huazhong University of Science & Technology,Wuhan, China
| | - Jiang Wu
- Medical Department, Wuhan Youfu Hospital,Wuhan, China
| | - Xin Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Jing Chen
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Affiliated Wuhan Mental Health Center,Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Shufang Zhang
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Affiliated Wuhan Mental Health Center,Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Yongjie Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Affiliated Wuhan Mental Health Center,Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China.
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Tyrer F, Zaccardi F, Khunti K, Morriss R. Incidence of Depression and First-Line Antidepressant Therapy in People with Obesity and Depression in Primary Care. Obesity (Silver Spring) 2020; 28:977-984. [PMID: 32266785 DOI: 10.1002/oby.22772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/08/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this study was to describe the age- and gender-specific incidence of depression, the dose-response relationship between BMI and risk of depression (Cox proportional hazards), and antidepressant drug prescribing in adults with overweight or obesity. METHODS A retrospective electronic health record study using the Clinical Practice Research Datalink was conducted to identify adults with overweight and obesity (≥ 18 years) with incident depression (no prior depression diagnosis in their records), followed up from 2000 to 2019. RESULTS Among 519,513 adults, incidence of depression was 9.2 per 1,000 person-years and was higher in women and in 40- to 59-year-old men who had severe obesity. Compared with having overweight, the hazard of depression increased with each BMI category as follows: 1.13 (30-34 kg/m2 ; 95% CI: 1.10-1.16), 1.34 (35-39 kg/m2 ; 1.29-1.40), 1.51 (40-44 kg/m2 ; 1.41-1.61), and 1.67 (45-49 kg/m2 ; 1.48-1.87), attenuating at BMI 50+ kg/m2 (1.54; 2.91-1.84). Antidepressants were prescribed as first-line therapy in two-thirds (66.3%) of cases. Prescriptions for fluoxetine reduced over time (20.4% [2000]; 8.8% [2018]), and prescriptions for sertraline increased (4.3% [2000]; 38.9% [2018]). CONCLUSIONS We recommend guidance on antidepressant drug prescribing and specific services for people with obesity and depression that address both symptoms and behaviors.
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Affiliation(s)
- Freya Tyrer
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Francesco Zaccardi
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Kamlesh Khunti
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Richard Morriss
- Institute of Mental Health, Jubilee Campus, University of Nottingham Innovation Park, University of Nottingham, Nottingham, UK
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Blackstone SR, Sangiorgio C, Johnson AK. Peer Recognition of Disordered Eating Behaviors: Implications for Improving Awareness through Health Education. American Journal of Health Education 2020. [DOI: 10.1080/19325037.2020.1740120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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29
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Lin CY, Guu TW, Lai HC, Peng CY, Chiang JYJ, Chen HT, Li TC, Yang SY, Su KP, Chang JPC. Somatic pain associated with initiation of interferon-alpha (IFN-α) plus ribavirin (RBV) therapy in chronic HCV patients: A prospective study. Brain Behav Immun Health 2020; 2:100035. [PMID: 34589826 PMCID: PMC8474510 DOI: 10.1016/j.bbih.2019.100035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/21/2019] [Accepted: 12/28/2019] [Indexed: 12/12/2022] Open
Abstract
Objective This study is aimed to investigate the association between interferon-alpha (IFN-α) plus ribavirin (RBV) treatment and emergence of somatic pain symptoms in patients with hepatitis C virus (HCV) over a 24-week treatment. Method In this prospective cohort study, 297 patients with HCV were evaluated at baseline and 2nd, 4th, 8th, 12th, 16th, 20th, and 24th week with structured Mini-International Neuropsychiatric Interview for Major Depressive Disorder (MDD) diagnosis and the Neurotoxicity Rating Scale (NRS) for somatic symptoms. Results Eighty-seven out of the 297 patients (29%) developed IFN-α induced depression and had significantly higher somatic pain symptoms as early as the 2nd week and at all the assessment time points (p < .001). Most depressed patients perceived greatest somatic pain at the 8th week of treatment. Moreover, NRS somatic pain scores after initial therapy strongly correlated with NRS somatic pain scores at all other assessment time points (p < .001). Conclusion IFN-α therapy induce significant somatic pain as early as the 2nd week of treatment in HCV patients who later developed MDD. Thus, initial NRS somatic pain score after initiation of IFN-α treatment may serve as a reference for the susceptibility of the individual to IFN-α induced depression.
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Affiliation(s)
- Chih Ying Lin
- School of Medicine, China Medical University (CMU), Taichung, Taiwan
- Mind-Body Interface Lab (MBI-Lab) and Department of Psychiatry, CMUH, Taichung, Taiwan
| | - Ta-Wei Guu
- Department Psychiatry, CMU Beigang Hospital, Yunlin, Taiwan
- Mind-Body Interface Lab (MBI-Lab) and Department of Psychiatry, CMUH, Taichung, Taiwan
| | - Hsueh-Chou Lai
- School of Medicine, China Medical University (CMU), Taichung, Taiwan
- Departement of Hepatogastroenterology, China Medial University Hospital, Taichung, Taiwan
| | - Cheng-Yuan Peng
- School of Medicine, China Medical University (CMU), Taichung, Taiwan
- Departement of Hepatogastroenterology, China Medial University Hospital, Taichung, Taiwan
| | - Jill Yi-Ju Chiang
- Mind-Body Interface Lab (MBI-Lab) and Department of Psychiatry, CMUH, Taichung, Taiwan
| | - Hui-Ting Chen
- Mind-Body Interface Lab (MBI-Lab) and Department of Psychiatry, CMUH, Taichung, Taiwan
| | - Tsai-Chung Li
- School of Medicine, China Medical University (CMU), Taichung, Taiwan
- China Medical University Graduate Institute of Biostatistics, Taiwan
| | - Shing-Yu Yang
- School of Medicine, China Medical University (CMU), Taichung, Taiwan
- China Medical University Graduate Institute of Biostatistics, Taiwan
| | - Kuan-Pin Su
- School of Medicine, China Medical University (CMU), Taichung, Taiwan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Mind-Body Interface Lab (MBI-Lab) and Department of Psychiatry, CMUH, Taichung, Taiwan
| | - Jane Pei-Chen Chang
- School of Medicine, China Medical University (CMU), Taichung, Taiwan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Mind-Body Interface Lab (MBI-Lab) and Department of Psychiatry, CMUH, Taichung, Taiwan
- Corresponding author. Department of Psychiatry, China Medical University Hospital, No. 2 Yu-Der Road, Taichung, 404, Taiwan.
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Mehltretter J, Rollins C, Benrimoh D, Fratila R, Perlman K, Israel S, Miresco M, Wakid M, Turecki G. Analysis of Features Selected by a Deep Learning Model for Differential Treatment Selection in Depression. Front Artif Intell 2020; 2:31. [PMID: 33733120 PMCID: PMC7861264 DOI: 10.3389/frai.2019.00031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/06/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Deep learning has utility in predicting differential antidepressant treatment response among patients with major depressive disorder, yet there remains a paucity of research describing how to interpret deep learning models in a clinically or etiologically meaningful way. In this paper, we describe methods for analyzing deep learning models of clinical and demographic psychiatric data, using our recent work on a deep learning model of STAR*D and CO-MED remission prediction. Methods: Our deep learning analysis with STAR*D and CO-MED yielded four models that predicted response to the four treatments used across the two datasets. Here, we use classical statistics and simple data representations to improve interpretability of the features output by our deep learning model and provide finer grained understanding of their clinical and etiological significance. Specifically, we use representations derived from our model to yield features predicting both treatment non-response and differential treatment response to four standard antidepressants, and use linear regression and t-tests to address questions about the contribution of trauma, education, and somatic symptoms to our models. Results: Traditional statistics were able to probe the input features of our deep learning models, reproducing results from previous research, while providing novel insights into depression causes and treatments. We found that specific features were predictive of treatment response, and were able to break these down by treatment and non-response categories; that specific trauma indices were differentially predictive of baseline depression severity; that somatic symptoms were significantly different between males and females, and that education and low income proved important psycho-social stressors associated with depression. Conclusion: Traditional statistics can augment interpretation of deep learning models. Such interpretation can lend us new hypotheses about depression and contribute to building causal models of etiology and prognosis. We discuss dataset-specific effects and ideal clinical samples for machine learning analysis aimed at improving tools to assist in optimizing treatment.
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Affiliation(s)
- Joseph Mehltretter
- Department of Computer Science, University of Southern California, Los Angeles, CA, United States
| | - Colleen Rollins
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - David Benrimoh
- Department of Psychiatry, McGill University, Montreal, QC, Canada.,Faculty of Medicine, McGill University, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada.,Aifred Health, Montreal, QC, Canada
| | | | - Kelly Perlman
- Douglas Mental Health University Institute, Montreal, QC, Canada.,Aifred Health, Montreal, QC, Canada
| | - Sonia Israel
- Douglas Mental Health University Institute, Montreal, QC, Canada.,Aifred Health, Montreal, QC, Canada
| | - Marc Miresco
- Aifred Health, Montreal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Marina Wakid
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada
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Ayalon L. Perceived Age Discrimination: A Precipitator or a Consequence of Depressive Symptoms? J Gerontol B Psychol Sci Soc Sci 2019; 73:860-869. [PMID: 27540094 DOI: 10.1093/geronb/gbw101] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 07/21/2016] [Indexed: 01/02/2023] Open
Abstract
Objectives The main purpose of the study was to examine a bidirectional temporal relationship between perceived age discrimination and depressive symptoms. A secondary goal was to examine whether the negative effects of perceived age discrimination on one's depressive symptoms are stronger among respondents older than 70 years old, compared with respondents between the ages of 51 and 70. Methods The Health and Retirement Study is a U.S. nationally representative sample of individuals over the age of 50 and their spouse of any age. A cross-lagged model was estimated to examine the reciprocal associations of depressive symptoms and perceived age discrimination, controlling for age, gender, education, ethnicity, marital status, employment status, satisfaction with financial status, number of medical conditions, mobility, strength and fine motor skills, and memory functioning. Results The baseline model for the overall sample resulted in adequate fit indices: CFI = .945, TLI = .940, RMSEA = .024 (90% CI = .023, .025). The cross-lagged effect of perceived age discrimination on depressive symptoms was nonsignificant (B [SE] = -.01 [.04], p = .82), whereas the cross-lagged effect of depressive symptoms on perceived age discrimination was small, but significant (B [SE] = .04 [.02], p = .03). This implies that higher levels of depressive symptoms precede a greater likelihood of perceived age discrimination, net of sociodemographic and clinical variables. The cross-lagged effects did not vary according to age group (51-70 vs >70 years old). Discussion The subjective nature of perceived age discrimination is discussed.
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Affiliation(s)
- Liat Ayalon
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
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32
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Fang M, Chen J, Guo L, Ma X. Gender Differences in Geriatric Depressive Symptoms in Rural China: The Role of Physical Housing Environments and Living Arrangements. Int J Environ Res Public Health 2019; 16:ijerph16050774. [PMID: 30836602 PMCID: PMC6427662 DOI: 10.3390/ijerph16050774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/14/2019] [Accepted: 02/20/2019] [Indexed: 11/25/2022]
Abstract
Physical housing environment and living arrangements are significant determinants of health, particularly in developing countries, although results are mixed. We conducted this study to examine the gender differences in geriatric depressive symptoms in rural China, and further explored the influence of housing environments and living arrangements on depressive symptoms. The data used for this study were from the third wave of the nationally representative China Health and Retirement Longitudinal Study (CHARLS) survey in 2015; a total of 2056 females and 2529 males were included in this study. According to the analysis findings, 46.15% of the respondents had depressive symptoms based on the CES-D, with a statistically significant gender difference of 54.32% in females and 39.50% in males. Logistic Regression findings identified that with regard to the items of physical housing environments, toilets without seats (OR = 1.349) and the unavailability of bathing facilities (OR = 1.469) were statistically associated with depressive symptoms among male participants, whereas for female participants the use of polluting fuels (OR = 1.248) and living arrangements (i.e., living with children, OR = 1.430) was statistically associated with depressive symptoms. Statistically significant gender differences were found for having shower or bath facilities and our findings underscored that physical housing environments and living arrangements were associated with depressive symptoms for both genders. Moreover, the study revealed that a slight gender difference exists in terms of geriatric depression in rural China. Females are more likely to become depressed than their male counterparts with the same characteristics.
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Affiliation(s)
- Mingwang Fang
- Department of Health-Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Jinfeng Chen
- Department of Health-Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Ling Guo
- Department of Health management, Chongqing Nursing Vocational College, Chongqing 402763, China.
| | - Xiao Ma
- Department of Health-Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu 610041, China.
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Geng J, Yan R, Shi J, Chen Y, Mo Z, Shao J, Wang X, Yao Z, Lu Q. Altered regional homogeneity in patients with somatic depression: A resting-state fMRI study. J Affect Disord 2019; 246:498-505. [PMID: 30599374 DOI: 10.1016/j.jad.2018.12.066] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 11/27/2018] [Accepted: 12/20/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Somatic symptoms are common among patients with major depressive disorder (MDD), and are known to negatively impact the course and severity of the disease. Although previous studies have attempted to explore the neuropathology of MDD, little is known regarding the neural basis of somatic symptoms in MDD. METHODS Resting-state functional magnetic resonance images of 28 MDD patients with somatic symptoms (somatic depression, SD), 30 patients without somatic symptoms (non-somatic depression, NSD) and 30 healthy controls (HC) were obtained. We investigated the neural basis of MDD with somatic symptoms based on the measure of regional homogeneity (ReHo). We also investigated whether the altered regional homogeneity may be correlated to any clinical features of depression. These comparison were also carried out in female and male subjects respectively. RESULTS The SD exhibited higher ReHo in the bilateral parahippocampus and left lingual gyrus than HC, as well as lower ReHo in the right frontal gyrus. Relative to NSD, the SD exhibited lower ReHo in the right middle frontal gyrus and left precentral gyrus. Furthermore, in the SD, ReHo in the left precentral gyrus was positively correlated with cognitive factor scores of the HAMD-17. In female subjects, SD exhibited increased ReHo in the right STG and decreased ReHo in the right MFG, relative to women of the NSD group. CONCLUSIONS Our preliminary findings indicated that abnormal ReHo in the frontal and temporal regions may play an important role in the neural basis of somatic depression.
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Millett CE, Phillips BE, Saunders EF. The Sex-specific Effects of LPS on Depressive-like Behavior and Oxidative Stress in the Hippocampus of the Mouse. Neuroscience 2019; 399:77-88. [DOI: 10.1016/j.neuroscience.2018.12.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 01/03/2023]
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Sun YC, Chen CL, Wen SH. Taiwanese depression questionnaire revisit: Factor structure and measurement invariance across genders. J Formos Med Assoc 2019; 118:1356-1361. [PMID: 30600133 DOI: 10.1016/j.jfma.2018.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/07/2018] [Accepted: 12/12/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND/PURPOSE Taiwanese Depression Questionnaire (TDQ) was widely used in Taiwan to measure individuals' proneness to depression. In light of well-established gender differences in the manifestation of depression, TDQ's structure invariance and measurement invariance across genders were examined in this study. METHODS Data from 2604 adults was analyzed. Exploratory factor analysis was first performed to explore the factor structure. Possible factor structures and the original 2-factor structure were then compared by confirmatory factor analysis (CFA). The best fitting model was tested for measurement invariance across genders using multi-group CFA. RESULTS EFA revealed 2 possible factor structures and suggested cross-loaded items deletion needed. This resulted in 4 models along with the original 2-factor structure to be tested in the follow-up CFA. Among the 5 models tested, the best-fitting model was the 3-factor solution with 3 cross-loaded items removed. The multi-group CFA performed on this 15-item TDQ revealed that the configural invariance, metrix invariance, and scalar invariance were all supported; partial strict invariance was supported when residual variances of items 1, 9, and 18 were set to vary. CONCLUSION The 15-item TDQ with a 3-factor structure reflects the manifestations of depression of Taiwanese general population well. Although the results of measurement invariance suggest no gender difference in factor structure, the partial strict invariance suggests that there is gender difference in the amount of variance captured by TDQ. Hence, examining gender differences in the predictive value of different factors regarding health behaviors or medical conditions may bring fruitful results.
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Affiliation(s)
- Yi-Chun Sun
- Department of Public Health, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chien-Lin Chen
- School of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan
| | - Shu-Hui Wen
- Department of Public Health, College of Medicine, Tzu Chi University, Hualien, Taiwan.
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de Sá Junior AR, Liebel G, de Andrade AG, Andrade LH, Gorenstein C, Wang YP. Can Gender and Age Impact on Response Pattern of Depressive Symptoms Among College Students? A Differential Item Functioning Analysis. Front Psychiatry 2019; 10:50. [PMID: 30809161 PMCID: PMC6379252 DOI: 10.3389/fpsyt.2019.00050] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 01/24/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Self-reported depressive complaints among college students might indicate different degrees of severity of depressive states. Through the framework of item response theory, we aim to describe the pattern of responses to items of the Beck Depression Inventory-II (BDI-II), in terms of endorsement probability and discrimination along the continuum of depression. Potential differential item functioning of the scale items of the BDI-II is investigated, by gender and age, to compare across sub-groups of students. Methods: The 21-item BDI-II was cross-sectionally administered to a representative sample of 12,677 Brazilian college students. Reliability was evaluated based on Cronbach's alpha coefficient. Severity (b i ) and discrimination (a) parameters of each BDI-II items were calculated through the graded response model. The influence of gender and age were tested for differential item functioning (DIF) within the item response theory-based approach. Results: The BDI-II presented good reliability (α = 0.91). Women and younger students significantly presented a higher likelihood of depression (cut-off > 13) than men and older counterparts. In general, participants endorsed more easily cognitive-somatic items than affective items of the scale. "Guilty feelings," "suicidal thoughts," and "loss of interest in sex" were the items that most likely indicated depression severity (b ≥ 3.60). However, all BDI-II items showed moderate-to-high discrimination (a ≥ 1.32) for depressive state. While two items were flagged for DIF, "crying" and "loss of interest in sex," respectively for gender and age, the global weight of these items on the total score was negligible. Conclusions: Although respondents' gender and age might present influence on response pattern of depressive symptoms, the measures of self-reported symptoms have not inflated severity scores. These findings provide further support to the validity of using BDI-II for assessing depression in academic contexts and highlight the value of considering gender- and age-related common symptoms of depression.
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Affiliation(s)
- Antonio Reis de Sá Junior
- Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Brazil.,Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
| | - Graziela Liebel
- Department of Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Arthur Guerra de Andrade
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.,Department of Neuroscience, Medical School, ABC Foundation, Santo André, Brazil
| | - Laura Helena Andrade
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
| | - Clarice Gorenstein
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.,Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Yuan-Pang Wang
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
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Adewuya AO, Coker OA, Atilola O, Ola BA, Zachariah MP, Adewumi T, Olugbile O, Fasawe A, Idris O. Gender difference in the point prevalence, symptoms, comorbidity, and correlates of depression: findings from the Lagos State Mental Health Survey (LSMHS), Nigeria. Arch Womens Ment Health 2018; 21:591-599. [PMID: 29594370 DOI: 10.1007/s00737-018-0839-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 03/22/2018] [Indexed: 01/06/2023]
Abstract
It is still unclear whether the gender difference in the rate of depression cuts across cultures or is specific to some depressive symptoms. This study evaluated the gender difference in current prevalence, symptoms, comorbidity, and correlates of depression in Lagos, Nigeria. A total of 11,246 adult participants (6525 females and 4712 males) in a face-to-face household survey were assessed for symptoms of depression. They were also assessed for symptoms of anxiety, somatic symptoms, alcohol and substance use disorders, and disability. The difference between the point prevalence for symptoms of depression in females (6.3%, s.e 0.3) and males (4.4%, s.e 0.3) was significant (OR 1.28, 95% CI 1.14-1.59). Compared to males, females had significantly higher rates for anhedonia (OR 1.20), hypersomnia (OR 2.15), fatigue (OR 1.49), guilt/worthless feeling (OR 1.41), poor concentration (OR 1.32), psychomotor retardation (OR 1.51), and suicidal ideation (OR 1.32). However, poor appetite (OR 0.69) and comorbidity with alcohol use (OR 0.25) was significantly lower in females compared to males. The significantly higher rates for depression in females were only restricted to below 45 years and higher socioeconomic status. Our study further contributed to the growing literature suggesting that the gender differences in rates of depression not only cut across many cultures, but most pronounced with atypical symptoms, not affected by recall bias and seems to disappear with increasing age. These need to be considered when formulating mental health policies for equitable and acceptable health services.
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Affiliation(s)
- Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria. .,Centre for Mental Health Research & Initiative, Ikeja, Lagos, Nigeria.
| | - Olurotimi A Coker
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Olayinka Atilola
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Bolanle A Ola
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Mathew P Zachariah
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Tomilola Adewumi
- Centre for Mental Health Research & Initiative, Ikeja, Lagos, Nigeria
| | | | | | - Olajide Idris
- Lagos State Ministry of Health, Alausa, Ikeja, Lagos, Nigeria
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Han KM, Ko YH, Yoon HK, Han C, Ham BJ, Kim YK. Relationship of depression, chronic disease, self-rated health, and gender with health care utilization among community-living elderly. J Affect Disord 2018; 241:402-410. [PMID: 30145510 DOI: 10.1016/j.jad.2018.08.044] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/17/2018] [Accepted: 08/12/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND We investigated the interactive effects of depressive symptoms and chronic diseases on health care utilization among elderly people and explored the potential moderating effect of gender and the mediating effect of self-rated health (SRH) on the association between depressive symptoms and health care utilization. METHOD We analyzed data from 5223 people aged 60 years or older living in the community from the Korea Welfare Panel Study in 2015. Depressive symptoms were measured using an 11-item version of the Center for Epidemiologic Studies Depression (CES-D-11) Scale and morbidity within 28 disease categories was assessed. Health care utilization was evaluated as the number of outpatient visits (OV), number of hospitalizations (NH), and number of days spent in the hospital (DH) during past year. Hierarchical moderated regression analyses were applied to investigate the interactive effects. We also adopted the mediation analysis method by Hayes and Preacher. RESULTS A significant interactive effect of CES-D-11 score and chronic disease on OV was found. A positive correlation between CES-D-11 score and OV was only observed in those with chronic disease. Gender had a moderating effect on the association of depression symptoms with OV, NH, and DH among elderly people with chronic disease. SRH had mediating effects on the association of CES-D-11 with OV, NH, and DH only among those with chronic disease. LIMITATIONS The severity or multimorbidity of chronic diseases, which could affect health care utilization among elderly were not considered. CONCLUSIONS We elucidated the complex aspects of the relationship between depressive symptoms and chronic disease and their interactive effects on health care utilization among elderly people, and identified important roles of gender and SRH.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea.
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea
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Tyuvina NA, Voronina EO, Balabanova VV, Tyulpin YG. Clinical features of depression in women compared with men. Nevrologiâ, nejropsihiatriâ, psihosomatika 2018. [DOI: 10.14412/2074-2711-2018-3-48-53] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective: to study the clinical features of depression in women compared with men. Patients and methods. 120 women aged 18-65 years with recurrent depressive disorder (RDD; ICI-10 F33) (a study group) and 67 men of the same age with RDD (a control group) were clinically examined using a specially designed schedule and the Montgomery-Asberg Depression Scale. Results. The clinical picture and the course of RDD have gender differences. The earlier onset of the disease in women with a large number of depressive attacks and lower quality remissions is due to the relationship and mutual influence of menstrual and reproductive function and depression. Such typical symptoms of endogenous depression, as slow thinking, anhedony, decreased sleep duration and early morning awakenings, as well as diurnal swings of mood with its deterioration in the morning, were characteristic for most women and men. The pattern of depression in women is more commonly characterized by anxiety; ideas of self-accusation; suicidal thoughts; avoidance of contacts with others; weakness; fatigue; decreased or increased appetite; sleep onset insomnia; lack of sleep feeling. That in men is more often marked by symptoms, such as melancholy; motor retardation; decreased motivation; somatic symptoms of depression (tachycardia, constipation); comorbid panic attacks; and concomitant diseases of the cardiovascular, respiratory and genitourinary systems. Men more frequently abuse alcohol and other psychoactive substances. Conclusion. The revealed features of depression in women and men will be able to more accurately diagnose and to prescribe adequate therapy.
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Affiliation(s)
- N. A. Tyuvina
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow
| | - E. O. Voronina
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow
| | - V. V. Balabanova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow
| | - Yu. G. Tyulpin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow
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Zhao D, Wu Z, Zhang H, Mellor D, Ding L, Wu H, Wu C, Huang J, Hong W, Peng D, Fang Y. Somatic symptoms vary in major depressive disorder in China. Compr Psychiatry 2018; 87:32-37. [PMID: 30195098 DOI: 10.1016/j.comppsych.2018.08.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/30/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE This study aimed to investigate the clinical characteristics of somatic symptoms of patients in China who suffer from major depressive disorder (MDD). METHOD 3273 patients who met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) MDD were recruited from 16 general hospitals and 16 mental health centers in China. Physicians and patients completed complementary customized depression disorder symptomatology questionnaires assessing the clinical characteristics of patients with MDD. RESULT 1. In this study we analyzed physician-recorded data. The major somatic symptoms in patients with MDD in China were insomnia (64.6%), pre-verbal physical complaints (46.9%), weight loss (38.5%), low appetite (37.6%), circulatory system complaints (31.3%), headache (31.3%), hyposexuality (31.0%), gastrointestinal symptom complaints (29.6%), and respiratory system complaints (29.6%). 2. Compared with MDD patients who sought medical help from mental health centers, MDD patients who sought medical help from general hospitals were more likely to suffer from urinary system complaints, headache, sensory system complaints, trunk pain, and nervous system complaints. A lower prevalence rate of insomnia and hyposexuality was also observed among MDD patients who visited general hospitals (p < .05). 3. Patients aged from 40 to 54 had the highest probability of pre-verbal physical complaints, respiratory system complaints, trunk pain, hyposexuality, limb pain and other pain conditions, while patients over 55 years of age had the lowest prevalence respiratory system complaints, hyposexuality, and other pain conditions, and they also had the highest rate of low appetite and insomnia. 4. Female patients appeared to exhibit higher rates of pre-verbal physical complaints, low appetite, and insomnia than male patients, but had fewer urinary systems complaints than male patients (p < .05). CONCLUSION The major somatic symptoms in patients with MDD in China are insomnia, pre-verbal physical complaints, weight loss, low appetite, circulatory system complaints, headache, hyposexuality, gastrointestinal system complaints, and respiratory system complaints. These symptoms vary by the type of medical setting to which patients present, and well as by age, and gender.
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Affiliation(s)
- Dongmei Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China; Shanghai Changning Mental Health Center, No 229, Xiehe Road, Changning District, Shanghai 200042, PR China
| | - Zhiguo Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Huifeng Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - David Mellor
- School of Psychology, Deakin University, Melbourne, Australia
| | - Lei Ding
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Haiyan Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Chuangxin Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Jia Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Wu Hong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Daihui Peng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China.
| | - Yiru Fang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China; Shanghai Key Laboratory of Psychotic Disorders, PR China; CAS Center for Excellence in Brain Science and Intelligence Technology, PR China.
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Kabutoya T, Hoshide S, Davidson KW, Kario K. Sex differences and the prognosis of depressive and nondepressive patients with cardiovascular risk factors: the Japan Morning Surge-Home Blood Pressure (J-HOP) study. Hypertens Res 2018; 41:965-72. [PMID: 30218049 DOI: 10.1038/s41440-018-0103-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/04/2018] [Accepted: 04/13/2018] [Indexed: 11/09/2022]
Abstract
Depression is associated with mortality in patients with cardiovascular risk factors. The frequency and severity of depression and the association between depression and cardiovascular events have sex-specific and ethnic differences. We conducted this study to evaluate the sex-specific difference in the association between depression and cardiovascular prognosis in patients with cardiovascular risk factors. We enrolled 4025 patients (64.7 ± 10.9 years, 53% women, 47% men) with cardiovascular risk factors in the Japan Morning Surge-Home Blood Pressure study. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). The follow-up period was 47 ± 24 months. The primary end points were all-cause mortality and nonfatal cardiovascular events. The BDI scores and the prevalence of depression were significantly higher in women than in men. When a BDI score of 16 was the cutoff, the primary end points in the depression group (n = 217) were significantly higher than those in the nondepression group (n = 1677) among men (adjusted hazard ratio 1.76, 95% confidence interval: 1.17, 2.64; P = 0.007). In women, the primary end points in the depression and nondepression groups were similar when BDI scores of 16, 14, and 10 were the cutoffs. In conclusion, depression defined by a BDI score ≥16 was associated with cardiovascular events in men with cardiovascular risk factors.
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Silverstein B. The Interaction Between Evolutionary and Historical Processes Produces the Gender Difference in Depressive Prevalence: Hypotheses, Evidence, and Need for Additional Research. Evolutionary Psychological Science 2018; 4:212-220. [DOI: 10.1007/s40806-017-0130-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Scott J, Davenport TA, Parker R, Hermens DF, Lind PA, Medland SE, Wright MJ, Martin NG, Gillespie NA, Hickie IB. Pathways to depression by age 16 years: Examining trajectories for self-reported psychological and somatic phenotypes across adolescence. J Affect Disord 2018; 230:1-6. [PMID: 29355726 DOI: 10.1016/j.jad.2017.12.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/16/2017] [Accepted: 12/03/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Sex differences in rates of depression emerge during adolescence. However, it is unclear whether symptom patterns and trajectories differ significantly according to gender in youth. Barriers to research include the fact that most self-report tools are weighted towards psychological rather than somatic symptoms. METHODS Data were collected on symptoms of depression in about 1800 individuals at ages 12, 14 and 16 years. Odds ratios and 95% confidence intervals were used to examine the trajectory of psychological and somatic phenotypes and self-reported depression caseness over time. RESULTS At age 12, 24% of participants met criteria for self-reported depression caseness. Although there was only a small incremental increase in the prevalence over time (about 5%), 57% of participants met criteria for self-reported depression caseness at least once. Generic symptoms at age 12 were associated with depression longitudinally, although early transition to caseness was reported in females only. Categorization as a psychological phenotype at age 12 predicted depression at age 14 and/or 16 years, especially in females. The somatic phenotype was more common in males, but showed a weaker association with self-reported depression caseness over time. LIMITATIONS Depression was assessed by self-report; only 30% of participants had ratings for age 12, 14 and 16. CONCLUSIONS Although sub-threshold psychological and somatic syndromes often co-occur in cases of self-reported depression in adolescence, longitudinally they may represent independent symptom trajectories. However, it is important to remember that self-reported depression is indicative of, but not confirmation of a depressive episode that meets diagnostic criteria.
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Affiliation(s)
- Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Brain & Mind Centre, University of Sydney, Sydney, Australia.
| | | | - Richard Parker
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Penelope A Lind
- Queensland Brain Institute, the University of Queensland, Brisbane, Australia
| | - Sarah E Medland
- Centre for Advanced Imaging, the University of Queensland, Brisbane, Australia
| | - Margaret J Wright
- Queensland Brain Institute, the University of Queensland, Brisbane, Australia; Centre for Advanced Imaging, the University of Queensland, Brisbane, Australia
| | - Nicholas G Martin
- Queensland Brain Institute, the University of Queensland, Brisbane, Australia
| | - Nathan A Gillespie
- Centre for Advanced Imaging, the University of Queensland, Brisbane, Australia; Virginia Institute for Psychiatric and Behavioral Genetics, VCU, Richmond, VA, USA
| | - Ian B Hickie
- Brain & Mind Centre, University of Sydney, Sydney, Australia
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Thompson AH, Bland RC. Gender similarities in somatic depression and in DSM depression secondary symptom profiles within the context of severity and bereavement. J Affect Disord 2018; 227:770-776. [PMID: 29689692 DOI: 10.1016/j.jad.2017.11.052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 11/12/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Most population studies report higher rates of depression among women than men, and some researchers have observed gender differences in depression symptoms overall, or in sub-groupings (e.g. somatic depression). However, gender symptom differences have been inconsistent, prompting this investigation of gender differences in secondary DSM symptom profiles in the context of bereavement status, age, and depression severity. METHODS Individuals with symptoms of core depression (flat affect or anhedonia) were selected from a large survey of adults in the Alberta, Canada workforce. Analyses involved the comparison of gender profiles across the seven DSM-IV secondary depressive symptoms plus a MANOVA of sex, bereavement, and age, with secondary symptoms comprising the dependent variable. RESULTS Gender profiles were very similar, irrespective of depression severity or bereavement. Secondary symptoms were marginally more common among women and more frequent among bereaved young adults, but there was no evidence for a gender-related somatic factor. LIMITATIONS First, data were gathered only for persons in the workforce and thus may not be generalizable to, for example, stay-at-home parents or those with employment issues. Second, the focus here is restricted to DSM symptoms, leaving risk factors, social roles, and brain functioning for separate investigation. Third, inferences were drawn from associations between groups of persons, rather than between individuals, requiring caution when speculating about individual attributes. CONCLUSIONS Gender differences in depression represent a difference in amount, not kind, suggesting that the range of depressive experiences is similar for men and women. There was no gender difference ascribable to somatic depression.
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Affiliation(s)
- Angus H Thompson
- Institute of Health Economics, Edmonton, Canada; University of Alberta, Edmonton, Canada.
| | - Roger C Bland
- University of Alberta, Edmonton, Canada; Alberta Health Services, Edmonton, Canada
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Ivanets NN, Tyuvina NA, Voronina EO, Balabanova VV. Comparative evaluation of depressive disorders in women and men. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:15-19. [DOI: 10.17116/jnevro201811811115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Carnevali L, Thayer JF, Brosschot JF, Ottaviani C. Heart rate variability mediates the link between rumination and depressive symptoms: A longitudinal study. Int J Psychophysiol 2017; 131:131-138. [PMID: 29117509 DOI: 10.1016/j.ijpsycho.2017.11.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/25/2017] [Accepted: 11/03/2017] [Indexed: 10/18/2022]
Abstract
Ruminative thinking about negative feelings has been prospectively associated with increases in depressive symptoms and heightened risk for new onsets of major depression. One putative pathophysiological mechanism underlying this link might be represented by autonomic nervous system dysfunction. The objective of this longitudinal study was to evaluate the interplay between rumination, autonomic function (as revealed by heart rate variability (HRV) analysis), and depressive symptoms in healthy young subjects, over a three-year period. Rumination and depressive symptoms were evaluated in twenty-two women and twenty men at three assessment points (Time 0, 1 and 2) by the score on the Ruminative Response Scale, and the Center for Epidemiological Studies Depression Scale, respectively. Vagally-mediated HRV was assessed in a laboratory session (Time 0) and in two ambulatory sessions at Time 1 and Time 2 (~13 and 34months after Time 0, respectively). Ruminative thinking was found to be (i) a stable trait characteristic, (ii) more prevalent in women than men, and (iii) positively correlated with depressive symptoms. Moreover, resting HRV was negatively correlated with both rumination and depressive symptoms. Finally, HRV at Time 1 mediated the relationship between rumination at Time 0 and depressive symptoms at Time 2. We conclude that autonomic dysfunction, specifically low vagal tone, may be prospectively implicated in the generation of depressive symptoms in a non-clinical setting.
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Affiliation(s)
- Luca Carnevali
- Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy; Stress Physiology Lab, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Italy
| | - Julian F Thayer
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Jos F Brosschot
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Cristina Ottaviani
- Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy; Department of Psychology, Sapienza University of Rome, Italy.
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Lamela D, Jongenelen I, Morais A, Figueiredo B. Cognitive-affective depression and somatic symptoms clusters are differentially associated with maternal parenting and coparenting. J Affect Disord 2017; 219:37-48. [PMID: 28505501 DOI: 10.1016/j.jad.2017.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 04/24/2017] [Accepted: 05/06/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Both depressive and somatic symptoms are significant predictors of parenting and coparenting problems. However, despite clear evidence of their co-occurrence, no study to date has examined the association between depressive-somatic symptoms clusters and parenting and coparenting. The current research sought to identify and cross-validate clusters of cognitive-affective depressive symptoms and nonspecific somatic symptoms, as well as to test whether clusters would differ on parenting and coparenting problems across three independent samples of mothers. METHOD Participants in Studies 1 and 3 consisted of 409 and 652 community mothers, respectively. Participants in Study 2 consisted of 162 mothers exposed to intimate partner violence. All participants prospectively completed self-report measures of depressive and nonspecific somatic symptoms and parenting (Studies 1 and 2) or coparenting (Study 3). RESULTS Across studies, three depression-somatic symptoms clusters were identified: no symptoms, high depression and low nonspecific somatic symptoms, and high depression and nonspecific somatic symptoms. The high depression-somatic symptoms cluster was associated with the highest levels of child physical maltreatment risk (Study 1) and overt-conflict coparenting (Study 3). No differences in perceived maternal competence (Study 2) and cooperative and undermining coparenting (Study 3) were found between the high depression and low somatic symptoms cluster and the high depression-somatic symptoms cluster. CONCLUSIONS The results provide novel evidence for the strong associations between clusters of depression and nonspecific somatic symptoms and specific parenting and coparenting problems. Cluster stability across three independent samples suggest that they may be generalizable. The results inform preventive approaches and evidence-based psychotherapeutic treatments.
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Scott TM, Byrd D, Arce Rentería M, Coulehan K, Miranda C, Fuentes A, Rivera Mindt M. The Combined Roles of Nonsomatic Depressive Symptomatology, Neurocognitive Function, and Current Substance Use in Medication Adherence in Adults Living With HIV Infection. J Assoc Nurses AIDS Care 2017; 29:178-189. [PMID: 28988793 DOI: 10.1016/j.jana.2017.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 08/10/2017] [Indexed: 01/01/2023]
Abstract
Depression, global neurocognitive (GNC) function, and substance use disorders (SUDs) are each associated with medication adherence in persons living with HIV (PLWH). Because somatic symptoms can inflate depression scores in PLWH, the role of nonsomatic depressive symptomatology (NSDS) should be considered in adherence. However, the combined roles of NSDS, GNC function, and current SUDs in predicting combined antiretroviral therapy (cART) adherence remain poorly understood. Forty PLWH (70% Latina/o; 30% non-Hispanic White) completed psychiatric/SUD, neurocognitive, and self-report cART adherence evaluations. Higher NSDS was associated with suboptimal adherence (p < .01), but optimal and suboptimal adherers did not differ in GNC function or current SUDs. Only NSDS was associated with suboptimal adherence, after accounting for GNC function and SUDs (p = .01). NSDS uniquely predicted self-reported adherence, beyond GNC function and current SUDs among ethnically diverse PLWH. Methodological issues between present and prior studies should also be considered.
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Fussner LM, Mancini KJ, Luebbe AM. Depression and Approach Motivation: Differential Relations to Monetary, Social, and Food Reward. J Psychopathol Behav Assess 2017. [DOI: 10.1007/s10862-017-9620-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Thunander Sundbom L, Bingefors K, Hedborg K, Isacson D. Are men under-treated and women over-treated with antidepressants? Findings from a cross-sectional survey in Sweden. BJPsych Bull 2017; 41:145-150. [PMID: 28584650 PMCID: PMC5451647 DOI: 10.1192/pb.bp.116.054270] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aims and method To examine gender differences in self-reported depression and prescribed antidepressants (ADs). The Hospital Anxiety and Depression Scale was used to assess depression, and information on prescribed ADs was obtained from the Swedish Prescribed Drug Register. Results Depression was reported by 11.7% of the participants (12.3% men and 11.2% women). ADs were prescribed for 7.6% of the participants (5.3% men, 9.8% women). Among men, 1.8% reported depression and used ADs, 10.5% reported depression but did not use ADs, and 3.6% used ADs but did not report depression. The corresponding figures for women were 2.6%, 8.6% and 7.2%. Clinical implications Men report depression to a greater extent than women but are prescribed ADs to a lesser extent, possibly a sign of under-treatment. Women are prescribed ADs without reporting depression more often than men, possibly a sign of over-treatment. Although the causes remain unclear, diagnostic and treatment guidelines should benefit from considering gender differences in these respects.
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