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Song H, Zhao Y, Hu C, Zhao C, Wang X, Xiao Z. Relationships among anxiety, depression, and health-related quality of life in adult epilepsy: A network analysis. Epilepsy Behav 2024; 154:109748. [PMID: 38640553 DOI: 10.1016/j.yebeh.2024.109748] [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: 12/02/2023] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE Comorbid depression and anxiety in patients with epilepsy (PWE) are common and frequently under-treated, thus, causing poor health-related quality of life (HRQoL). However, little is known regarding the interconnections between anxious/depressive symptoms and the dimensions of HRQoL. Therefore, we conducted a network analysis to explore these relationships in detail among Chinese adult PWE. METHODS A cohort of adult PWE was consecutively recruited from the First Affiliated Hospital of Chongqing Medical University. HRQoL, depression, and anxiety were measured with Quality of Life in Epilepsy Inventory-31, Neurological Disorders Depression Inventory for Epilepsy, and Generalized Anxiety Disorder 7-Item Scale, respectively. A regularized partial correlation network was constructed to investigate the interconnections between symptoms of anxiety/depression and the dimensions of HRQoL. We calculated expected influence (EI) and bridge expected influence (BEI) values to identify the most influential nodes. RESULTS A total of 396 PWE were enrolled in this study, 78.1% of whom had focal onset epilepsy. The prevalence of anxiety and depression was 30.3% and 28.8%, respectively. The symptoms "frustrated" and "uncontrollable worry" had the highest EI values, whereas "emotional well-being", "seizure worry", "difficulty finding pleasure", and "nervousness or anxiety" had the highest BEI values. CONCLUSION This study provides new insights into the relationships among anxiety, depression, and HRQoL. Critical central symptoms and bridge symptoms identified in the network might help to quickly identify PWE comorbid anxiety and depression in busy outpatient settings, thereby enabling early intervention and enhancing quality of life.
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Affiliation(s)
- Hui Song
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuping Zhao
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chunmei Hu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Neurology, The People's Hospital of Nanchuan, Chongqing, China
| | - Chenxiao Zhao
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuefeng Wang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Zheng Xiao
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Ma H, Zhao M, Liu Y, Wei P. Network analysis of depression and anxiety symptoms and their associations with life satisfaction among Chinese hypertensive older adults: a cross-sectional study. Front Public Health 2024; 12:1370359. [PMID: 38562253 PMCID: PMC10983850 DOI: 10.3389/fpubh.2024.1370359] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Background Hypertension is one of the most prevalent chronic diseases among the older adult population in China and older adults with hypertension are more susceptible to mental health problems. This study aimed to explore the network structure of depression and anxiety, and their association with life satisfaction (LS) in older adults with hypertension. Methods A total of 4,993 hypertensive individuals aged 60 and above were selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2017-2018). The design of the CLHLS study was approved by the Campus Institutional Review Board of Duke University (Pro00062871) and the Biomedical Ethics Committee of Peking University (IRB00001052-13,074). The Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and the Generalized Anxiety Disorder Scale-7 (GAD-7) were used to assess depressive and anxiety symptoms. Central and bridge symptoms were identified via "Expected Influence" and "Bridge Expected Influence", respectively. Network stability was assessed using the case-dropping bootstrap technique. Results Network analysis identified CESD3 (Feeling blue/depressed), GAD4 (Trouble relaxing), and GAD2 (Uncontrollable worry) as the most influential central symptoms in the network of depression and anxiety. Concurrently, GAD1 (Nervousness or anxiety), CESD10 (Sleep disturbances), and CESD1 (Feeling bothered) stand as critical bridge symptoms between depression and anxiety disorders. Moreover, CESD7 (Lack of happiness) exhibited the strongest negative correlation with LS in Chinese hypertensive older adults. Conclusion This exploratory study represents the first investigation to examine the mutual relationship between depressive and anxiety symptoms among Chinese hypertensive older adults. Interventions addressing targeting bridge symptoms have the potential to alleviate depressive and anxiety symptoms. Furthermore, improving happiness, hope, and sleep quality in this population may mitigate the adverse effects of depression and anxiety on LS.
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Affiliation(s)
| | | | | | - Pingmin Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
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Wi D, Park C, Ransom JC, Flynn DM, Doorenbos AZ. A network analysis of pain intensity and pain-related measures of physical, emotional, and social functioning in US military service members with chronic pain. Pain Med 2024; 25:231-238. [PMID: 37944054 PMCID: PMC10906708 DOI: 10.1093/pm/pnad148] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE The purpose of this study was to apply network analysis methodology to better understand the relationships between pain-related measures among people with chronic pain. METHODS We analyzed data from a cross-sectional sample of 4614 active duty service members with chronic pain referred to 1 military interdisciplinary pain management center between 2014 and 2021. Using a combination of Patient-Reported Outcomes Measurement Information System measures and other pain-related measures, we applied the "EBICglasso" algorithm to create regularized partial correlation networks that would identify the most influential measures. RESULTS Pain interference, depression, and anxiety had the highest strength in these networks. Pain catastrophizing played an important role in the association between pain and other pain-related health measures. Bootstrap analyses showed that the networks were very stable and the edge weights accurately estimated in 2 analyses (with and without pain catastrophizing). CONCLUSIONS Our findings offer new insights into the relationships between symptoms using network analysis. Important findings highlight the strength of association between pain interference, depression and anxiety, which suggests that if pain is to be treated depression and anxiety must also be addressed. What was of specific importance was the role that pain catastrophizing had in the relationship between pain and other symptoms suggesting that pain catastrophizing is a key symptom on which to focus for treatment of chronic pain.
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Affiliation(s)
- Dahee Wi
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL 60612, United States
| | - Chang Park
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL 60612, United States
| | - Jeffrey C Ransom
- Physical Performance Service Line, Madigan Army Medical Center, Interdisciplinary Pain Management Center, Joint Base Lewis-McChord, WA 98431, United States
| | - Diane M Flynn
- Physical Performance Service Line, Madigan Army Medical Center, Interdisciplinary Pain Management Center, Joint Base Lewis-McChord, WA 98431, United States
| | - Ardith Z Doorenbos
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL 60612, United States
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98195, United States
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Zhang Y, Cui Y, Li Y, Lu H, Huang H, Sui J, Guo Z, Miao D. Network analysis of depressive and anxiety symptoms in older Chinese adults with diabetes mellitus. Front Psychiatry 2024; 15:1328857. [PMID: 38347882 PMCID: PMC10859512 DOI: 10.3389/fpsyt.2024.1328857] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024] Open
Abstract
Background The move away from investigating mental disorders as whole using sum scores to the analysis of symptom-level interactions using network analysis has provided new insights into comorbidities. The current study explored the dynamic interactions between depressive and anxiety symptoms in older Chinese adults with diabetes mellitus (DM) and identified central and bridge symptoms in the depression-anxiety network to provide potential targets for prevention and intervention for depression and anxiety. Methods This study used a cross-sectional design with data from the 2017-2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A regularized partial correlation network for depressive and anxiety symptoms was estimated based on self-reported scales completed by 1685 older adults with DM aged 65 years or older. Depressive and anxiety symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) and the Seven-Item Generalized Anxiety Disorder Scale (GAD-7), respectively. Expected influence (EI) and bridge expected influence (BEI) indices were calculated for each symptom. Results According to cutoff scores indicating the presence of depression and anxiety, the prevalences of depression and anxiety in our sample were 52.9% and 12.8%, respectively. The comorbidity rate of depression and anxiety was 11.5%. The six edges with the strongest regularized partial correlations were between symptoms from the same disorder. "Feeling blue/depressed", "Nervousness or anxiety", "Uncontrollable worry", "Trouble relaxing", and "Worry too much" had the highest EI values. "Nervousness or anxiety" and "Everything was an effort" exhibited the highest BEI values. Conclusion Central and bridge symptoms were highlighted in this study. Targeting these symptoms may be effective in preventing the comorbidity of depressive and anxiety symptoms and facilitate interventions in older Chinese adults with DM who are at risk for or currently have depressive and anxiety symptoms.
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Affiliation(s)
- Yajuan Zhang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Yi Cui
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Yijun Li
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Hongliang Lu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - He Huang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Jiaru Sui
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Danmin Miao
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
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Cai H, Chen MY, Li XH, Zhang L, Su Z, Cheung T, Tang YL, Malgaroli M, Jackson T, Zhang Q, Xiang YT. A network model of depressive and anxiety symptoms: a statistical evaluation. Mol Psychiatry 2024:10.1038/s41380-023-02369-5. [PMID: 38238548 DOI: 10.1038/s41380-023-02369-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Although network analysis studies of psychiatric syndromes have increased in recent years, most have emphasized centrality symptoms and robust edges. Broadening the focus to include bridge symptoms within a systematic review could help to elucidate symptoms having the strongest links in network models of psychiatric syndromes. We conducted this systematic review and statistical evaluation of network analyses on depressive and anxiety symptoms to identify the most central symptoms and bridge symptoms, as well as the most robust edge indices of networks. METHODS A systematic literature search was performed in PubMed, PsycINFO, Web of Science, and EMBASE databases from their inception to May 25, 2022. To determine the most influential symptoms and connections, we analyzed centrality and bridge centrality rankings and aggregated the most robust symptom connections into a summary network. After determining the most central symptoms and bridge symptoms across network models, heterogeneity across studies was examined using linear logistic regression. RESULTS Thirty-three studies with 78,721 participants were included in this systematic review. Seventeen studies with 23 cross-sectional networks based on the Patient Health Questionnaire (PHQ) and Generalized Anxiety Disorder (GAD-7) assessments of clinical and community samples were examined using centrality scores. Twelve cross-sectional networks based on the PHQ and GAD-7 assessments were examined using bridge centrality scores. We found substantial variability between study samples and network features. 'Sad mood', 'Uncontrollable worry', and 'Worrying too much' were the most central symptoms, while 'Sad mood', 'Restlessness', and 'Motor disturbance' were the most frequent bridge centrality symptoms. In addition, the connection between 'Sleep' and 'Fatigue' was the most frequent edge for the depressive and anxiety symptoms network model. CONCLUSION Central symptoms, bridge symptoms and robust edges identified in this systematic review can be viewed as potential intervention targets. We also identified gaps in the literature and future directions for network analysis of comorbid depression and anxiety.
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Affiliation(s)
- Hong Cai
- Unit of medical psychology and behavior medicine, school of public health, Guangxi Medical University, Nanning, Guangxi, China
| | - Meng-Yi Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Xiao-Hong Li
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Atlanta VA Medical Center, Atlanta, GA, USA
| | - Matteo Malgaroli
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Cesário HPSDF, Silva FCO, Ferreira MKA, de Menezes JESA, Dos Santos HS, Marques da Fonseca A, Nogueira CES, Marinho MM, Marinho ES, Teixeira AMR, Silveira ER, Pessoa ODL. Anxiolytic effects of N-(4,5-dihydro-5-oxo-1,2-dithiolo-[4,3,b]-pyrrole-6-yl)- N-methylformamide, a pyrroloformamide isolated from a marine Streptomyces sp., in adult zebrafish by the 5-HT system. J Biomol Struct Dyn 2024; 42:445-460. [PMID: 37038661 DOI: 10.1080/07391102.2023.2193988] [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: 10/27/2022] [Accepted: 03/15/2023] [Indexed: 04/12/2023]
Abstract
General anxiety disorders are among the most prevalent mental health problems worldwide. The emergence and development of anxiety disorders can be due to genetic (30-50%) or non-genetic (50-70%) factors. Despite medical progress, available pharmacotherapies are sometimes ineffective or can cause undesirable side effects. Thus, it becomes necessary to discover new safe and effective drugs against anxiety. This study evaluated the anxiolytic effect in adult zebrafish (Danio rerio) of a natural pyrroloformamide (PFD), N-(4,5-dihydro-5-oxo-1,2-dithiolo-[4,3,b]-pyrrole-6-yl)-N-methylformamide, isolated from a Streptomyces sp. bacterium strain recovered from the ascidian Eudistoma vannamei. The complete structure of PFD was determined by a detailed NMR analysis, including 1H-13C and 1H-15N-HBMC data. In addition, conformational and DFT computational studies also were performed. A group of fishes (n = 6) was treated orally with PFD (0.1, 0.5 and 1.0 mg/mL; 20 μL) and subjected to locomotor activity and light/dark tests, as well as, acute toxicity 96 h. The involvement of the GABAergic and serotonergic (5-HT) systems was investigated using flumazenil (a silent modulator of GABA receptor) and 5-HT1, 5-HT2A/2C and 5-HTR3A/3B receptors antagonists, known as pizotifen, granisetron and cyproheptadine, respectively. PFD was nontoxic, reduced locomotor activity and promoted the anxiolytic effect in zebrafish. Flumazenil did not inhibit the anxiolytic effect of the PFD via the GABAergic system. This effect was reduced by a pretreatment with pizotifen and granisetron, and was not reversed after treatment with cyproheptadine. Molecular docking and dynamics studies confirmed the interaction of PFD with the 5-HT receptor.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
| | | | | | | | - Hélcio S Dos Santos
- Laboratory of Chemistry of Natural Products, Synthesis and Biocatalysis of Organic Compounds, Vale do Acaraú University, Sobral, CE, Brazil
| | - Aluísio Marques da Fonseca
- Academic Master in Sociobiodiversity and Sustainable Technologies - MASTS, Institute of Engineering and Sustainable Development, University of International Integration of Afro-Brazilian Lusofonia, Acarape, CE, Brazil
| | - Carlos Emídio S Nogueira
- Department of Biological Chemistry, Regional University of Cariri, Crato, CE, Brazil
- Department of Physics, Regional University of Cariri, Crato, CE, Brazil
| | - Marcia M Marinho
- Laboratory of Chemistry of Natural Products, Synthesis and Biocatalysis of Organic Compounds, Vale do Acaraú University, Sobral, CE, Brazil
| | | | - Alexandre Magno R Teixeira
- Department of Biological Chemistry, Regional University of Cariri, Crato, CE, Brazil
- Course of Physics, State University of Ceará, Fortaleza, CE, Brazil
| | - Edilberto R Silveira
- Department of Organic and Inorganic Chemistry, Science Center, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Otília Deusdênia L Pessoa
- Department of Organic and Inorganic Chemistry, Science Center, Federal University of Ceará, Fortaleza, CE, Brazil
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Nakamura H, Sugihara G, Hara K, Inaji M, Noha M, Takumi I, Watanabe M, Takahashi H, Maehara T, Yamamoto H, Takagi S. Seizure-related stress and arousal responses mediate a relationship between anxiety trait and state in epilepsy. Epilepsy Behav 2023; 147:109442. [PMID: 37716325 DOI: 10.1016/j.yebeh.2023.109442] [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: 07/14/2023] [Revised: 08/25/2023] [Accepted: 09/05/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Epilepsy causes substantial psychological distress and anxiety, primarily due to seizures. However, the impact of stress responses and changes in arousal and their association with anxiety patterns in patients with epilepsy (PWE) remains unclear. This study aimed to investigate the relationships among seizures, stress and arousal characteristics, and trait and state anxiety characteristics in PWE. METHODS Our sample consisted of 159 outpatients with epilepsy recruited from five institutions in Japan in 2020. Participants completed the State-Trait Anxiety Inventory-Form JYZ (STAI) and the Japanese-Stress Arousal Check List (J-SACL). We analyzed the correlations between inventory scores and clinical information. Using principal component analysis (PCA), we derived epilepsy-specific stress/arousal characteristics, which accounted for high arousal and low-stress levels, termed epilepsy-specific stress or arousal response (ESAR), from the J-SACL scores. We conducted a mediation analysis to assess the mediating role of ESAR in the relationship between traits and state anxiety. RESULTS We found significant correlations between J-SACL stress and arousal factors (r = -0.845, p < 0.001), ESAR and seizure frequency (r = -0.29, p < 0.001), ESAR and trait anxiety scores on the STAI (r = -0.77, p < 0.0001), and ESAR and state anxiety scores on the STAI (r = -0.60, p < 0.0001). Mediation analysis supported by the Monte Carlo method revealed that ESAR significantly mediated the association between trait and state anxiety. CONCLUSIONS These findings elucidate the epilepsy-specific stress and arousal characteristics and their roles in mediating traits and state anxiety. These results may reflect the long-term clinical course and unique emotion recognition tendencies in epilepsy.
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Affiliation(s)
- Hironobu Nakamura
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Tokyo, Japan; Hara Clinic, Kanagawa, Japan
| | - Genichi Sugihara
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Keiko Hara
- Hara Clinic, Kanagawa, Japan; Department of Respiratory and Nervous System Science, Biomedical Laboratory Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motoki Inaji
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Noha
- Department of Neurosurgery, Okinawa Red Cross Hospital, Okinawa, Japan
| | - Ichiro Takumi
- Department of Neurosurgery, St. Marianna University School of Medicine, Kanagawa, Japan
| | | | - Hidehiko Takahashi
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Tokyo, Japan; Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hitoshi Yamamoto
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Shunsuke Takagi
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Tokyo, Japan; Sleep Research Institute, Waseda University, 513 Waseda-Tsurumakicho, Shinjuku, Tokyo 162-0041 Japan.
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Maciaszek J, Pawłowski T, Hadryś T, Misiak B. Baseline depressive symptoms as predictors of efficacy and tolerability of the treatment with duloxetine: a network analysis approach. Front Psychiatry 2023; 14:1210289. [PMID: 37398593 PMCID: PMC10312095 DOI: 10.3389/fpsyt.2023.1210289] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/02/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Depression is considered one of the most prevalent and burdensome mental disorders. Only 50-60% of patients respond to first-line treatment. Individuals with depression might benefit from personalized treatment, tailored to the individual needs of the patient. In this study, we aimed to explore the baseline characteristics of depressive symptoms associated with a good response to duloxetine treatment using a network analysis. Additionally, the relationship between baseline psychopathological symptoms and treatment tolerability was assessed. Methods The sample of 88 drug-free patients with active depressive episode, who started monotherapy with increasing doses of duloxetine were evaluated. The Hamilton Depression Rating Scale (HAM-D) was used to assess depression severity and the UKU side effect rating scale to monitor adverse drug reactions (ADRs). A network analysis that explored interactions of specific baseline depression symptoms, treatment efficacy and tolerability was performed. Results The node representing duloxetine treatment efficacy was directly connected to the nodes representing the first HAM-D item ("depressed mood") (edge weight = 0.191) and duloxetine dose (edge weight = 0.144). The node representing ADRs was directly connected to only one node representing the baseline score of the HAM-D anxiety (psychic) item (edge weight = 0.263). Discussion Our findings indicate that individuals with depression presenting greater levels of depressed mood and lower levels of anxiety symptoms might better respond to the treatment with duloxetine in terms of efficacy and tolerability.
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9
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Micoulaud-Franchi JA, Gauld C, Mcgonigal A. Networked vision of epilepsy and mental symptoms: Proposal for a "city map of traffic lights". Epilepsy Behav 2023; 141:109118. [PMID: 36801164 DOI: 10.1016/j.yebeh.2023.109118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 02/19/2023]
Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- Sleep Medicine Unit, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France; UMR CNRS 6033 SANPSY, University Hospital of Bordeaux, 33 076 Bordeaux, France.
| | - Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, France
| | - Aileen Mcgonigal
- Epilepsy Unit, Neurosciences Centre, Mater Hospital and Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Queensland Brain Institute, The University of Queensland, Brisbane, Australia
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10
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Yang T, Guo Z, Cao X, Zhu X, Zhou Q, Li X, Wang H, Wang X, Wu L, Wu S, Liu X. Network analysis of anxiety and depression in the functionally impaired elderly. Front Public Health 2022; 10:1067646. [PMID: 36530716 PMCID: PMC9751796 DOI: 10.3389/fpubh.2022.1067646] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Background Evidence from previous studies has confirmed that functionally impaired elderly individuals are susceptible to comorbid anxiety and depression. Network theory holds that the comorbidity emerges from interactions between anxiety and depression symptoms. This study aimed to investigate the fine-grained relationships among anxiety and depression symptoms in the functionally impaired elderly and identify central and bridge symptoms to provide potential targets for intervention of these two comorbid disorders. Methods A total of 325 functionally impaired elderly individuals from five communities in Xi'an, China, were recruited for our investigation. The GAD-7 and PHQ-9 were used to measure anxiety and depression, respectively. SPSS 22.0 software was used for descriptive statistics, and R 4.1.1 software was used for network model construction, expected influence (EI) evaluation and bridge expected influence (BEI) evaluation. Results In the network, there were 35 edges (indicating partial correlations between symptoms) across the communities of anxiety and depression, among which the strongest edge was A1 "Nervousness or anxiety"-D2 "Depressed or sad mood." A2 "Uncontrollable worry" and D2 "Depressed or sad mood" had the highest EI values in the network, while A6 "Irritable" and D7 "Concentration difficulties" had the highest BEI values of their respective community. In the flow network, the strongest direct edge of D9 "Thoughts of death" was with D6 "Feeling of worthlessness." Conclusion Complex fine-grained relationships exist between anxiety and depression in functionally impaired elderly individuals. "Uncontrollable worry," "depressed or sad mood," "irritable" and "concentration difficulties" are identified as the potential targets for intervention of anxiety and depression. Our study emphasizes the necessity of suicide prevention for functionally impaired elderly individuals, and the symptom "feeling of worthlessness" can be used as an effective target.
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Affiliation(s)
- Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Xiaoqin Cao
- Xijing Hospital, Air Force Medical University, Shaanxi, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Qin Zhou
- Xijing Hospital, Air Force Medical University, Shaanxi, China
| | - Xinhong Li
- Tangdu Hospital, Air Force Medical University, Shaanxi, China
| | - Hui Wang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Xiuchao Wang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China,Shengjun Wu
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China,*Correspondence: Xufeng Liu
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