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Klimes-Dougan B, Papke V, Carosella KA, Wiglesworth A, Mirza SA, Espensen-Sturges TD, Meester C. Basal and reactive cortisol: A systematic literature review of offspring of parents with depressive and bipolar disorders. Neurosci Biobehav Rev 2022; 135:104528. [PMID: 35031342 DOI: 10.1016/j.neubiorev.2022.104528] [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: 09/03/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/19/2022]
Abstract
One of the most consistent biological findings in the study of affective disorders is that those with depression commonly show abnormal cortisol response, which suggests dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Children of parents with mood disorders offer the opportunity to explore the biological pathways that may confer risk for psychopathology. This review explores basal and reactive cortisol in the offspring of parents who are currently depressed or have had a history of a depressive or bipolar disorder. Using PRISMA guidelines, search terms yielded 2002 manuscripts. After screening, 87 of these manuscripts were included. Results from the literature suggest that while the degree and direction of dysregulation varies, offspring of a parent with depression tend to show elevations in both basal (particularly morning and evening) and reactive (tentatively for social stressors) cortisol levels. There were few studies focused on offspring of parents with bipolar disorder. This review also discusses implications and recommendations for future research regarding the HPA axis in the intergenerational transmission of depressive disorders.
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Affiliation(s)
- Bonnie Klimes-Dougan
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA.
| | - Victoria Papke
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Katherine A Carosella
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Andrea Wiglesworth
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Salahudeen A Mirza
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Tori D Espensen-Sturges
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Christina Meester
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
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Ahlers NE, Weiss SJ. Exposure to particulate matter, prenatal depressive symptoms and HPA axis dysregulation. Heliyon 2021; 7:e07166. [PMID: 34141927 PMCID: PMC8187961 DOI: 10.1016/j.heliyon.2021.e07166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/07/2021] [Accepted: 05/26/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The prevalence of depression during pregnancy is on the rise, affecting women's well-being and their children's health outcomes. Preliminary studies suggest that exposure to air pollution during pregnancy may play a role in development of depressive symptoms. In addition, pollution has been linked to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, our brain's primary stress response system. The purpose of this study was to examine the association of air pollution exposure during pregnancy to prenatal depressive symptoms. We also evaluated whether cortisol, the hormonal endpoint of HPA activation, mediated the relationship between exposure to pollution and prenatal depression. METHODS Women were recruited in obstetric clinics during their third trimester of pregnancy. They completed the Patient Health Questionnaire-9 to assess depression and provided salivary samples at 4 times during the day for 2 days. Four measures of cortisol were calculated from salivary assays: average cortisol level, cortisol awakening response (CAR), diurnal cortisol slope (DCS), and area under the curve (AUCG). We acquired data on particulate matter with a diameter of 2.5 μm (PM2.5) or less within each woman's residential area from public records of the air quality control district. Structural equation modeling was used to analyze the aims. RESULTS Increased prenatal exposure to PM2.5 across pregnancy was associated with more severe depressive symptoms during the 3rd trimester (β = 0.14, p = 0.02). Greater PM2.5 exposure also had significant relationships with both higher cortisol AUCG (β = 15.933, p = 0.005) and average cortisol levels (β = 0.018, p = 0.023) among women. However, no cortisol parameter appeared to mediate the relationship between PM2.5 exposure and depressive symptoms. CONCLUSIONS Findings suggest pregnancy may be a critical window of sensitivity to PM2.5 exposure that escalates depression risk and induces activation of the HPA axis, evidenced in greater overall cortisol concentration. Further research is needed to identify mechanisms underlying the effects of particulate matter, especially potential methylation of glucocorticoid or serotonin transporter genes that may elicit changes in both depression and the stress response system. In addition, assessment of depression appears warranted for pregnant women in regions known for high pollution.
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Affiliation(s)
- Nina E. Ahlers
- Department of Community Health Systems, University of California, San Francisco, CA, USA
| | - Sandra J. Weiss
- Department of Community Health Systems, University of California, San Francisco, CA, USA
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Nedic Erjavec G, Sagud M, Nikolac Perkovic M, Svob Strac D, Konjevod M, Tudor L, Uzun S, Pivac N. Depression: Biological markers and treatment. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:110139. [PMID: 33068682 DOI: 10.1016/j.pnpbp.2020.110139] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [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: 07/01/2020] [Revised: 10/06/2020] [Accepted: 10/10/2020] [Indexed: 12/14/2022]
Abstract
Nowadays depression is considered as a systemic illness with different biological mechanisms involved in its etiology, including inflammatory response, hypothalamic-pituitary-adrenal (HPA) axis dysregulation and neurotransmitter and neurotrophic systems imbalance. Novel "omics" approaches, such as metabolomics and glycomics provide information about altered metabolic pathways and metabolites, as well as disturbances in glycosylation processes affected by or causing the development of depression. The clinical diagnosis of depression continues to be established based on the presence of the specific symptoms, but due to its heterogeneous underlying biological background, that differs according to the disease stage, there is an unmet need for treatment response biomarkers which would facilitate the process of appropriate treatment selection. This paper provides an overview of the role of major stress response system, the HPA axis, and its dysregulation in depression, possible involvement of neurotrophins, especially brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor and insulin-like growth factor-1, in the development of depression. Article discusses how activated inflammation processes and increased cytokine levels, as well as disturbed neurotransmitter systems can contribute to different stages of depression and could specific metabolomic and glycomic species be considered as potential biomarkers of depression. The second part of the paper includes the most recent findings about available medical treatment of depression. The described biological factors impose an optimistic conclusion that they could represent easy obtainable biomarkers potentially predicting more personalized treatment and diagnostic options.
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Affiliation(s)
- Gordana Nedic Erjavec
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Marina Sagud
- The University of Zagreb School of Medicine, Salata 3, 10000 Zagreb, Croatia; University Hospital Center Zagreb, Department of Psychiatry, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Matea Nikolac Perkovic
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Dubravka Svob Strac
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Marcela Konjevod
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Lucija Tudor
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Sandra Uzun
- University Hospital Center Zagreb, Department for Anesthesiology, Reanimatology, and Intensive Care, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Nela Pivac
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia.
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Durmusoglu E, Ugurlu O, Akan S, Simsek F, Kizilates G, Kitis O, Ozkul BA, Eker C, Coburn KL, Gonul AS. Hippocampal shape alterations in healthy young women with familial risk for unipolar depression. Compr Psychiatry 2018; 82:7-13. [PMID: 29367060 DOI: 10.1016/j.comppsych.2018.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/30/2017] [Accepted: 01/04/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Although reduced hippocampal volume (HCV) is a common finding in depression, it is unclear whether the structural alterations leading to reduction of HCV are pre-existing risk factors before the onset of clinical symptoms or a cumulative process that begins with the onset of clinical symptoms. The aim of the present study was to understand the anatomical status of the hippocampus prior to the clinical symptoms in subjects with high familial risk for depression. METHODS Twenty-seven young women (mean age: 22.3 ± 2.1 years) who were at high risk for familial unipolar depression and 26 age- and gender-matched healthy controls (mean age: 22.1 ± 2.1 years) with low familial risk for depression were included in the study. Total hippocampal volumes were measured by manual tracing. For 3D shape differences, the spherical harmonic basis functions (SPHARM) software was used. The segmented images were parameterized, and the point-to-point based group difference was compared by the Hotelling's T-squared test with total brain volume and Beck Depression Scale as covariates. RESULTS Although there was no difference in overall HCVs, shape analyses revealed a contracted area on the Cornu Ammonis (CA) 1 region of the right hippocampus head in the high-risk group compared to the low-risk group. Cross-sectional design and small sample size, including only females, were the main limitations of this study. CONCLUSION This study with shape analyses provided data suggesting that local structural hippocampal alterations in the CA1 region might be associated with depression vulnerability in women at high risk.
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Affiliation(s)
- Ece Durmusoglu
- SoCAT Lab Department of Psychiatry, School of Medicine Ege University, Izmir, Turkey
| | - Onur Ugurlu
- SoCAT Lab Department of Psychiatry, School of Medicine Ege University, Izmir, Turkey; Ege University, Faculty of Science, Department of Mathematics, Bornova, Izmir, Turkey
| | - Sebnem Akan
- SoCAT Lab Department of Psychiatry, School of Medicine Ege University, Izmir, Turkey; Department of Neuroscience, Institute of Health Sciences, Ege University, Izmir, Turkey
| | - Fatma Simsek
- SoCAT Lab Department of Psychiatry, School of Medicine Ege University, Izmir, Turkey; Department of Psychosis Studies, Institute of Psychiatry, Kings' College London, UK
| | - Gozde Kizilates
- SoCAT Lab Department of Psychiatry, School of Medicine Ege University, Izmir, Turkey; Ege University, Faculty of Science, Department of Mathematics, Bornova, Izmir, Turkey
| | - Omer Kitis
- SoCAT Lab Department of Psychiatry, School of Medicine Ege University, Izmir, Turkey; Department of Neuroradiology, School of Medicine Ege University, Izmir, Turkey
| | - Burcu Aksoy Ozkul
- SoCAT Lab Department of Psychiatry, School of Medicine Ege University, Izmir, Turkey; Department of Neuroscience, Institute of Health Sciences, Ege University, Izmir, Turkey; Department of Psychiatric Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Cagdas Eker
- SoCAT Lab Department of Psychiatry, School of Medicine Ege University, Izmir, Turkey; Affective Disorders Unit, Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey; CUBIT Lab & Department of Psychiatry, School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Kerry L Coburn
- Mercer University School of Medicine, Department of Psychiatry and Behavioral Sciences, Macon, GA, USA
| | - Ali Saffet Gonul
- SoCAT Lab Department of Psychiatry, School of Medicine Ege University, Izmir, Turkey; Mercer University School of Medicine, Department of Psychiatry and Behavioral Sciences, Macon, GA, USA.
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Jesulola E, Micalos P, Baguley IJ. Understanding the pathophysiology of depression: From monoamines to the neurogenesis hypothesis model - are we there yet? Behav Brain Res 2017; 341:79-90. [PMID: 29284108 DOI: 10.1016/j.bbr.2017.12.025] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/19/2017] [Accepted: 12/22/2017] [Indexed: 02/07/2023]
Abstract
A number of factors (biogenic amine deficiency, genetic, environmental, immunologic, endocrine factors and neurogenesis) have been identified as mechanisms which provide unitary explanations for the pathophysiology of depression. Rather than a unitary construct, the combination and linkage of these factors have been implicated in the pathogenesis of depression. That is, environmental stressors and heritable genetic factors acting through immunologic and endocrine responses initiate structural and functional changes in many brain regions, resulting in dysfunctional neurogenesis and neurotransmission which then manifest as a constellation of symptoms which present as depression.
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Affiliation(s)
- Emmanuel Jesulola
- Paramedicine Discipline, Charles Sturt University, Bathurst Campus, NSW Australia.
| | - Peter Micalos
- Paramedicine Discipline, Charles Sturt University, Bathurst Campus, NSW Australia
| | - Ian J Baguley
- Brain Injury Rehabilitation Service, Westmead Hospital, Hawkesbury Rd, Wentworthville, NSW Australia
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Cordero MI, Moser DA, Manini A, Suardi F, Sancho-Rossignol A, Torrisi R, Rossier MF, Ansermet F, Dayer AG, Rusconi-Serpa S, Schechter DS. Effects of interpersonal violence-related post-traumatic stress disorder (PTSD) on mother and child diurnal cortisol rhythm and cortisol reactivity to a laboratory stressor involving separation. Horm Behav 2017; 90:15-24. [PMID: 28189641 DOI: 10.1016/j.yhbeh.2017.02.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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: 05/11/2016] [Revised: 12/23/2016] [Accepted: 02/05/2017] [Indexed: 01/09/2023]
Abstract
Women who have experienced interpersonal violence (IPV) are at a higher risk to develop posttraumatic stress disorder (PTSD), with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and impaired social behavior. Previously, we had reported impaired maternal sensitivity and increased difficulty in identifying emotions (i.e. alexithymia) among IPV-PTSD mothers. One of the aims of the present study was to examine maternal IPV-PTSD salivary cortisol levels diurnally and reactive to their child's distress in relation to maternal alexithymia. Given that mother-child interaction during infancy and early childhood has important long-term consequences on the stress response system, toddlers' cortisol levels were assessed during the day and in response to a laboratory stressor. Mothers collected their own and their 12-48month-old toddlers' salivary samples at home three times: 30min after waking up, between 2-3pm and at bedtime. Moreover, mother-child dyads participated in a 120-min laboratory session, consisting of 3 phases: baseline, stress situation (involving mother-child separation and exposure to novelty) and a 60-min regulation phase. Compared to non-PTSD controls, IPV-PTSD mothers - but not their toddlers, had lower morning cortisol and higher bedtime cortisol levels. As expected, IPV-PTSD mothers and their children showed blunted cortisol reactivity to the laboratory stressor. Maternal cortisol levels were negatively correlated to difficulty in identifying emotions. Our data highlights PTSD-IPV-related alterations in the HPA system and its relevance to maternal behavior. Toddlers of IPV-PTSD mothers also showed an altered pattern of cortisol reactivity to stress that potentially may predispose them to later psychological disorders.
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Affiliation(s)
- Maria I Cordero
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK; Research Unit, Child and Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland.
| | - Dominik A Moser
- Research Unit, Child and Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland
| | - Aurelia Manini
- Research Unit, Child and Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland
| | - Francesca Suardi
- Research Unit, Child and Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland
| | - Ana Sancho-Rossignol
- Research Unit, Child and Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland
| | - Raffaella Torrisi
- Research Unit, Child and Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland
| | - Michel F Rossier
- Clinical Chemistry and Toxicology Service, Hôpital du Valais, Sion, Switzerland
| | - François Ansermet
- Research Unit, Child and Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland; Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alexandre G Dayer
- Research Unit, Child and Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland; Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sandra Rusconi-Serpa
- Research Unit, Child and Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland
| | - Daniel S Schechter
- Research Unit, Child and Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland; Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Developmental Neuroscience, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
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