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Koumoula A, Marchionatti LE, Karagiorga VE, Schafer JL, Simioni A, Caye A, Serdari A, Kotsis K, Basta M, Athanasopoulou L, Dafoulis V, Tatsiopoulou P, Zilikis N, Vergouli E, Balikou P, Kapsimalli E, Mitropoulou A, Tzotzi A, Klavdianou N, Zeleni D, Mitroulaki S, Botzaki A, Gerostergios G, Samiotakis G, Moschos G, Giannopoulou I, Papanikolaou K, Angeli K, Scarmeas N, Emanuele J, Schuster K, Karyotaki E, Kalikow L, Pronoiti K, Merikangas KR, Szatmari P, Cuijpers P, Georgiades K, Milham MP, Corcoran M, Burke S, Koplewicz H, Salum GA. Understanding priorities and needs for child and adolescent mental health in Greece from multiple informants: an open resource dataset. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02400-2. [PMID: 38558204 DOI: 10.1007/s00787-024-02400-2] [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: 05/17/2023] [Accepted: 02/15/2024] [Indexed: 04/04/2024]
Abstract
The Child and Adolescent Mental Health Initiative (CAMHI) aims to enhance mental health care capacity for children and adolescents across Greece. Considering the need for evidence-based policy, the program developed an open-resource dataset for researching the field within the country. A comprehensive, mixed-method, community-based research was conducted in 2022/2023 assessing the current state, needs, barriers, and opportunities according to multiple viewpoints. We surveyed geographically distributed samples of 1,756 caregivers, 1,201 children/adolescents, 404 schoolteachers, and 475 health professionals using validated instruments to assess mental health symptoms, mental health needs, literacy and stigma, service use and access, professional practices, training background, and training needs and preferences. Fourteen focus groups were conducted with informants from diverse populations (including underrepresented minorities) to reach an in-depth understanding of those topics. A dataset with quantitative and qualitative findings is now available for researchers, policymakers, and society [ https://osf.io/crz6h/ and https://rpubs.com/camhi/sdashboard ]. This resource offers valuable data for assessing the needs and priorities for child and adolescent mental health care in Greece. It is now freely available to consult, and is expected to inform upcoming research and evidence-based professional training. This initiative may inspire similar ones in other countries, informing methodological strategies for researching mental health needs.
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Affiliation(s)
- Anastasia Koumoula
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Lauro Estivalete Marchionatti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
- Department of Psychiatry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil
| | - Vasiliki Eirini Karagiorga
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Julia Luiza Schafer
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
- Department of Psychiatry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil
| | - André Simioni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Arthur Caye
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
- Department of Psychiatry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil
| | - Aspasia Serdari
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Department of Child and Adolescent Psychiatry, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Kotsis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Basta
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Lilian Athanasopoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Vaios Dafoulis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Paraskevi Tatsiopoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Nikos Zilikis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Evangelia Vergouli
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Panagiota Balikou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Efstathia Kapsimalli
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Andromachi Mitropoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Alexandra Tzotzi
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Nikanthi Klavdianou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Domna Zeleni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Sotiria Mitroulaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Anna Botzaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Giorgos Gerostergios
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Giorgos Samiotakis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Giorgos Moschos
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Ioanna Giannopoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- 2nd Department of Psychiatry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Papanikolaou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Department of Child Psychiatry, Agia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Angeli
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Nikolaos Scarmeas
- National and Kapodistrian University of Athens (NKUA), Athens, Greece
- Columbia University, New York, NY, USA
| | - Jill Emanuele
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Kenneth Schuster
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Eirini Karyotaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Department of Clinical Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lily Kalikow
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Katerina Pronoiti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bathesda, USA
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Pim Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Michael P Milham
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Mimi Corcoran
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Sarah Burke
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Harold Koplewicz
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Giovanni Abrahão Salum
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA.
- Child Mind Institute, 101 E 56th St, New York, USA.
- Department of Psychiatry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil.
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Lateef TM, Dey D, Leroux A, Cui L, Xiao M, Zipunnikov V, Merikangas KR. Association Between Electronic Diary-Rated Sleep, Mood, Energy, and Stress With Incident Headache in a Community-Based Sample. Neurology 2024; 102:e208102. [PMID: 38266217 DOI: 10.1212/wnl.0000000000208102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/07/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to examine the diurnal links between average and changes in average levels of prospectively rated mood, sleep, energy, and stress as predictors of incident headache in a community-based sample. METHODS This observational study included structured clinical diagnostic assessment of both headache syndromes and mental disorders and electronic diaries that were administered 4 times per day for 2 weeks yielding a total of 4,974 assessments. The chief outcomes were incident morning (am) and later-day (pm) headaches. Generalized linear mixed-effects models were used to evaluate the average and lagged values of predictors including subjectively rated mood, anxiety, energy, stress, and sleep quality and objectively measured sleep duration and efficiency on incident am and pm headaches. RESULTS The sample included 477 participants (61% female), aged 7 through 84 years. After adjusting for demographic and clinical covariates and emotional states, incident am headache was associated with lower average (ß = -0.206*; confidence intervals: -0.397 to -0.017) and a decrease in average sleep quality on the prior day (ß = -0.172*; confidence interval: -0.305, -0.039). Average stress and changes in subjective energy levels on the prior day were associated with incident headaches but with different valence for am (decrease) (ß = -0.145* confidence interval: -0.286, -0.005) and pm (increase) (ß = 0.157*; confidence interval: 0.032, 0.281) headache. Mood and anxiety disorders were not significantly associated with incident headache after controlling for history of a diagnosis of migraine. DISCUSSION Both persistent and acute changes in arousal states manifest by subjective sleep quality and energy are salient precursors of incident headaches. Whereas poorer sleep quality and decreased energy on the prior day were associated with incident morning headache, an increase in energy and greater average stress were associated with headache onsets later in the day. Different patterns of predictors of morning and later-day incident headache highlight the role of circadian rhythms in the manifestations of headache. These findings may provide insight into the pathophysiologic processes underlying migraine and inform clinical intervention and prevention. Tracking these systems in real time with mobile technology provides a valuable ancillary tool to traditional clinical assessments.
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Affiliation(s)
- Tarannum M Lateef
- From the Children's National Health System (T.M.L.), Pediatric Specialists of Virginia, and George Washington University of Medicine; Intramural Research Program (T.M.L., D.D., L.C., K.R.M.), Section on Developmental Genetic Epidemiology, National Institute of Mental Health, Bethesda, MD; Department of Biostatistics and Informatics (A.L.), University of Colorado School of Public Health, Denver; Child Mind Institute (M.X.), New York; Department of Biostatistics (V.Z.); and Department of Epidemiology (K.R.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Debangan Dey
- From the Children's National Health System (T.M.L.), Pediatric Specialists of Virginia, and George Washington University of Medicine; Intramural Research Program (T.M.L., D.D., L.C., K.R.M.), Section on Developmental Genetic Epidemiology, National Institute of Mental Health, Bethesda, MD; Department of Biostatistics and Informatics (A.L.), University of Colorado School of Public Health, Denver; Child Mind Institute (M.X.), New York; Department of Biostatistics (V.Z.); and Department of Epidemiology (K.R.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Andrew Leroux
- From the Children's National Health System (T.M.L.), Pediatric Specialists of Virginia, and George Washington University of Medicine; Intramural Research Program (T.M.L., D.D., L.C., K.R.M.), Section on Developmental Genetic Epidemiology, National Institute of Mental Health, Bethesda, MD; Department of Biostatistics and Informatics (A.L.), University of Colorado School of Public Health, Denver; Child Mind Institute (M.X.), New York; Department of Biostatistics (V.Z.); and Department of Epidemiology (K.R.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lihong Cui
- From the Children's National Health System (T.M.L.), Pediatric Specialists of Virginia, and George Washington University of Medicine; Intramural Research Program (T.M.L., D.D., L.C., K.R.M.), Section on Developmental Genetic Epidemiology, National Institute of Mental Health, Bethesda, MD; Department of Biostatistics and Informatics (A.L.), University of Colorado School of Public Health, Denver; Child Mind Institute (M.X.), New York; Department of Biostatistics (V.Z.); and Department of Epidemiology (K.R.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mike Xiao
- From the Children's National Health System (T.M.L.), Pediatric Specialists of Virginia, and George Washington University of Medicine; Intramural Research Program (T.M.L., D.D., L.C., K.R.M.), Section on Developmental Genetic Epidemiology, National Institute of Mental Health, Bethesda, MD; Department of Biostatistics and Informatics (A.L.), University of Colorado School of Public Health, Denver; Child Mind Institute (M.X.), New York; Department of Biostatistics (V.Z.); and Department of Epidemiology (K.R.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Vadim Zipunnikov
- From the Children's National Health System (T.M.L.), Pediatric Specialists of Virginia, and George Washington University of Medicine; Intramural Research Program (T.M.L., D.D., L.C., K.R.M.), Section on Developmental Genetic Epidemiology, National Institute of Mental Health, Bethesda, MD; Department of Biostatistics and Informatics (A.L.), University of Colorado School of Public Health, Denver; Child Mind Institute (M.X.), New York; Department of Biostatistics (V.Z.); and Department of Epidemiology (K.R.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kathleen R Merikangas
- From the Children's National Health System (T.M.L.), Pediatric Specialists of Virginia, and George Washington University of Medicine; Intramural Research Program (T.M.L., D.D., L.C., K.R.M.), Section on Developmental Genetic Epidemiology, National Institute of Mental Health, Bethesda, MD; Department of Biostatistics and Informatics (A.L.), University of Colorado School of Public Health, Denver; Child Mind Institute (M.X.), New York; Department of Biostatistics (V.Z.); and Department of Epidemiology (K.R.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Rovero M, Preisig M, Marques-Vidal P, Strippoli MPF, Vollenweider P, Vaucher J, Berney A, Merikangas KR, Vandeleur CL, Glaus J. Subtypes of major depressive disorders and objectively measured physical activity and sedentary behaviors in the community. Compr Psychiatry 2024; 129:152442. [PMID: 38070447 DOI: 10.1016/j.comppsych.2023.152442] [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: 07/18/2023] [Revised: 11/24/2023] [Accepted: 12/03/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Lack of physical activity (PA) and high sedentary behavior (SB) may enhance mental health problems, including depression, and are associated with increased mortality. Aside from a large body of research on major depressive disorder (MDD) assessed as an entity and either PA or SB, few studies have examined associations among subtypes of MDD and both PA and SB simultaneously derived from wrist-worn accelerometers. Accordingly, our aim was to explore the associations among MDD subtypes (atypical, melancholic, combined atypical-melancholic and unspecified) and four actigraphy-derived behaviors combining the levels of PA and SB. METHODS The sample stemmed from CoLaus|PsyCoLaus, a population-based cohort study, consisting of 2375 participants (55.1% women; mean age: 62.4 years) who wore an accelorometer for 14 days after a physical exam and subsequently completed a semi-structured psychiatric interview. Activity behaviors were defined according to the combination of the levels of moderate-to-vigorous intensity PA and SB. Associations of remitted MDD subtypes, current MDD and physical inactivity behaviors were assessed using multinomial logistic regression, adjusted for socio-demographic characteristics, a history of anxiety, alcohol and drug use disorders and cardiovascular risk factors. RESULTS In the fully adjusted model, participants with the remitted combined atypical-melancholic subtype had a higher risk of being more physically inactive. CONCLUSIONS Our findings suggest that low PA and high SB are not restricted to the duration of depressive episodes in people with atypical and melancholic episodes. The lack of PA and high SB in this group of depressive patients exposes them to an additional long-term cardiovascular risk and measures to increase PA may be particularly fruitful in this MDD subgroup.
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Affiliation(s)
- Maulde Rovero
- Faculty of Medicine, University of Zurich, Switzerland
| | - Martin Preisig
- Center for Research in Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Marie-Pierre F Strippoli
- Center for Research in Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Julien Vaucher
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Switzerland; Department of Medicine and Specialties, Internal Medicine, Fribourg Hospital and University of Fribourg, Switzerland
| | - Alexandre Berney
- Department of Psychiatry, Psychiatric Liaison Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Caroline L Vandeleur
- Center for Research in Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland.
| | - Jennifer Glaus
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
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Chen AA, Weinstein SM, Adebimpe A, Gur RC, Gur RE, Merikangas KR, Satterthwaite TD, Shinohara RT, Shou H. Similarity-based multimodal regression. Biostatistics 2023:kxad033. [PMID: 38058018 DOI: 10.1093/biostatistics/kxad033] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 10/07/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023] Open
Abstract
To better understand complex human phenotypes, large-scale studies have increasingly collected multiple data modalities across domains such as imaging, mobile health, and physical activity. The properties of each data type often differ substantially and require either separate analyses or extensive processing to obtain comparable features for a combined analysis. Multimodal data fusion enables certain analyses on matrix-valued and vector-valued data, but it generally cannot integrate modalities of different dimensions and data structures. For a single data modality, multivariate distance matrix regression provides a distance-based framework for regression accommodating a wide range of data types. However, no distance-based method exists to handle multiple complementary types of data. We propose a novel distance-based regression model, which we refer to as Similarity-based Multimodal Regression (SiMMR), that enables simultaneous regression of multiple modalities through their distance profiles. We demonstrate through simulation, imaging studies, and longitudinal mobile health analyses that our proposed method can detect associations between clinical variables and multimodal data of differing properties and dimensionalities, even with modest sample sizes. We perform experiments to evaluate several different test statistics and provide recommendations for applying our method across a broad range of scenarios.
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Affiliation(s)
- Andrew A Chen
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Sarah M Weinstein
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, PA 19122, USA
| | - Azeez Adebimpe
- Penn Lifespan Informatics & Neuroimaging Center, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute Penn Medicine and CHOP, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute Penn Medicine and CHOP, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD 20892, USA
| | - Theodore D Satterthwaite
- Penn Lifespan Informatics & Neuroimaging Center, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Russell T Shinohara
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Haochang Shou
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA
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5
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Abstract
OBJECTIVE The authors examined recent trends in incidence of psychotic disorders, demographic characteristics, and comorbid psychiatric and medical conditions among six racial/ethnic groups. METHOD A retrospective cohort study design was used to examine the incidence of psychotic disorders across race/ethnicity groups and comorbid psychiatric and medical conditions among members of Kaiser Permanente Northern California from 2009 to 2019 (N=5,994,758). Poisson regression was used to assess changes in annual incidence, and Cox proportional hazards and logistic regression models adjusted for age and sex were used to test correlates and consequences. RESULTS Overall, the incidence of nonaffective psychotic disorders decreased slightly over the study period. Compared with White members, the risk of nonaffective psychosis diagnosis was higher among Black (hazard ratio=2.13, 95% CI=2.02-2.24) and American Indian or Alaskan Native (AIAN) (hazard ratio=1.85, 95% CI=1.53-2.23) members and lower among Asian (hazard ratio=0.72, 95% CI=0.68-0.76) and Hispanic (hazard ratio=0.91, 95% CI=0.87-0.96) members, as well as those whose race/ethnicity was categorized as "other" (hazard ratio=0.92, 95% CI=0.86-0.99). Compared with White members, the risk of affective psychosis diagnosis adjusted for age and sex was higher among Black (hazard ratio=1.76, 95% CI=1.62-1.91), Hispanic (hazard ratio=1.09, 95% CI=1.02-1.16), and AIAN (hazard ratio=1.38, 95% CI=1.00-1.90) members and lower among Asian (hazard ratio=0.77, 95% CI=0.71-0.83), Native Hawaiian or other Pacific Islander (hazard ratio=0.69, 95% CI=0.48-0.99), and "other" (hazard ratio=0.86, 95% CI=0.77-0.96) members. Psychotic disorders were associated with significantly higher odds of suicide (odds ratio=2.65, 95% CI=2.15-3.28), premature death (odds ratio=1.30, 95% CI=1.22-1.39), and stroke (odds ratio=1.64, 95% CI=1.55-1.72) and lower odds of health care utilization (odds ratio=0.44, 95% CI=0.42-0.47). CONCLUSIONS This study demonstrates racial and ethnic variation in incident psychotic disorder diagnoses in the United States, compared with non-Hispanic Whites. Individuals diagnosed with psychosis face a greater burden of other negative health outcomes and lower odds of health care utilization, reflecting personal and economic impacts. Identifying risk factors for elevated rates and protective influences in subgroups can inform strategies for prevention and interventions to ameliorate severe consequences of psychotic syndromes.
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Affiliation(s)
- Winston Chung
- Department of Psychiatry, Kaiser Permanente Northern California, San Francisco (Chung); Division of Research, Kaiser Permanente Northern California, Oakland (Jiang); Center for the Developing Brain, Child Mind Institute, New York (Milham); Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, N.Y. (Milham); Genetic Epidemiology Research Branch, NIMH, Bethesda, Md. (Merikangas, Paksarian)
| | - Sheng-Fang Jiang
- Department of Psychiatry, Kaiser Permanente Northern California, San Francisco (Chung); Division of Research, Kaiser Permanente Northern California, Oakland (Jiang); Center for the Developing Brain, Child Mind Institute, New York (Milham); Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, N.Y. (Milham); Genetic Epidemiology Research Branch, NIMH, Bethesda, Md. (Merikangas, Paksarian)
| | - Michael P Milham
- Department of Psychiatry, Kaiser Permanente Northern California, San Francisco (Chung); Division of Research, Kaiser Permanente Northern California, Oakland (Jiang); Center for the Developing Brain, Child Mind Institute, New York (Milham); Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, N.Y. (Milham); Genetic Epidemiology Research Branch, NIMH, Bethesda, Md. (Merikangas, Paksarian)
| | - Kathleen R Merikangas
- Department of Psychiatry, Kaiser Permanente Northern California, San Francisco (Chung); Division of Research, Kaiser Permanente Northern California, Oakland (Jiang); Center for the Developing Brain, Child Mind Institute, New York (Milham); Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, N.Y. (Milham); Genetic Epidemiology Research Branch, NIMH, Bethesda, Md. (Merikangas, Paksarian)
| | - Diana Paksarian
- Department of Psychiatry, Kaiser Permanente Northern California, San Francisco (Chung); Division of Research, Kaiser Permanente Northern California, Oakland (Jiang); Center for the Developing Brain, Child Mind Institute, New York (Milham); Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, N.Y. (Milham); Genetic Epidemiology Research Branch, NIMH, Bethesda, Md. (Merikangas, Paksarian)
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Stapp EK, Zipunnikov V, Leroux A, Cui L, Husky MM, Dey D, Merikangas KR. Specificity of affective dynamics of bipolar and major depressive disorder. Brain Behav 2023; 13:e3134. [PMID: 37574463 PMCID: PMC10498074 DOI: 10.1002/brb3.3134] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/10/2023] [Accepted: 06/08/2023] [Indexed: 08/15/2023] Open
Abstract
OBJECTIVE Here, we examine whether the dynamics of the four dimensions of the circumplex model of affect assessed by ecological momentary assessment (EMA) differ among those with bipolar disorder (BD) and major depressive disorder (MDD). METHODS Participants aged 11-85 years (n = 362) reported momentary sad, anxious, active, and energetic dimensional states four times per day for 2 weeks. Individuals with lifetime mood disorder subtypes of bipolar-I, bipolar-II, and MDD derived from a semistructured clinical interview were compared to each other and to controls without a lifetime history of psychiatric disorders. Random effects from individual means, inertias, innovation (residual) variances, and cross-lags across the four affective dimensions simultaneously were derived from multivariate dynamic structural equation models. RESULTS All mood disorder subtypes were associated with higher levels of sad and anxious mood and lower energy than controls. Those with bipolar-I had lower average activation, and lower energy that was independent of activation, compared to MDD or controls. However, increases in activation were more likely to perpetuate in those with bipolar-I. Bipolar-II was characterized by higher lability of sad and anxious mood compared to bipolar-I and controls but not MDD. Compared to BD and controls, those with MDD exhibited cross-augmentation of sadness and anxiety, and sadness blunted energy. CONCLUSION Bipolar-I is more strongly characterized by activation and energy than sad and anxious mood. This distinction has potential implications for both specificity of intervention targets and differential pathways underlying these dynamic affective systems. Confirmation of the longer term stability and generalizability of these findings in future studies is necessary.
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Affiliation(s)
- Emma K. Stapp
- Genetic Epidemiology Research BranchNational Institute of Mental HealthBethesdaMarylandUSA
- Department of Epidemiology, Milken Institute School of Public HealthGeorge Washington UniversityWashington, D.C.USA
| | - Vadim Zipunnikov
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Andrew Leroux
- Department of Biostatistics and InformaticsUniversity of Colorado School of Public HealthAuroraColoradoUSA
| | - Lihong Cui
- Genetic Epidemiology Research BranchNational Institute of Mental HealthBethesdaMarylandUSA
| | - Mathilde M. Husky
- Bordeaux Population Health Research CenterUniversity of BordeauxBordeauxFrance
| | - Debangan Dey
- Genetic Epidemiology Research BranchNational Institute of Mental HealthBethesdaMarylandUSA
| | - Kathleen R. Merikangas
- Genetic Epidemiology Research BranchNational Institute of Mental HealthBethesdaMarylandUSA
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7
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Horowitz LM, Mournet AM, Sheftall A, He JP, Lowry NJ, Aguinaldo LD, Sullivant SA, Wharff EA, Merikangas KR, Pao M, Bridge JA. Assessing the Validity of the Ask Suicide-Screening Questions in Black Youth. J Acad Consult Liaison Psychiatry 2023; 64:332-335. [PMID: 36273745 PMCID: PMC10115908 DOI: 10.1016/j.jaclp.2022.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/14/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Given the increasing rates of suicide and nonfatal suicide attempts among Black youth in the United States, it is crucial that screening tools are valid in identifying Black youth at risk of suicide. OBJECTIVE This study assessed the validity of the Ask Suicide-Screening Questions (ASQ) among Black youth. METHODS This analysis used pooled data from 3 ASQ validation studies of pediatric medical patients aged 10-21 years. All participants completed the ASQ and the gold standard Suicidal Ideation Questionnaire. RESULTS Of the 1083 participants, 330 (30.5%) were non-Hispanic Black and 753 (69.5%) were non-Hispanic White. ASQ psychometric properties for Black and White participants were equivalent (sensitivity = 94% vs. 90.9%; specificity = 91.4% vs. 91.8%, respectively). CONCLUSIONS There were no significant differences in ASQ psychometric properties between Black and White youth, indicating that the ASQ is valid for screening Black youth at risk of suicide.
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Affiliation(s)
- Lisa M Horowitz
- Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD.
| | - Annabelle M Mournet
- Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD
| | - Arielle Sheftall
- The Center for Suicide Prevention and Research at the Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH
| | - Jian-Ping He
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, MD
| | - Nathan J Lowry
- Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD
| | - Laika D Aguinaldo
- Department of Psychiatry, University of California, San Diego, San Diego, CA
| | - Shayla A Sullivant
- Division of Developmental and Behavioral Health, Children's Mercy Kansas City, Kansas City, MO; University of Missouri-Kansas City (UMKC) School of Medicine, Kansas City, MO
| | | | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, MD
| | - Maryland Pao
- Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD
| | - Jeffrey A Bridge
- The Center for Suicide Prevention and Research at the Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH; Departments of Pediatrics and Psychiatry & Behavioral Health, The Ohio State University College of Medicine, Columbus, OH
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8
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Glaus J, Kang SJ, Guo W, Lamers F, Strippoli MPF, Leroux A, Dey D, Plessen KJ, Vaucher J, Vollenweider P, Zipunnikov V, Merikangas KR, Preisig M. Objectively assessed sleep and physical activity in depression subtypes and its mediating role in their association with cardiovascular risk factors. J Psychiatr Res 2023; 163:325-336. [PMID: 37253320 DOI: 10.1016/j.jpsychires.2023.05.042] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/23/2023] [Accepted: 05/15/2023] [Indexed: 06/01/2023]
Abstract
The aims of this study were to investigate the associations of major depressive disorder (MDD) and its subtypes (atypical, melancholic, combined, unspecified) with actigraphy-derived measures of sleep, physical activity and circadian rhythms; and test the potentially mediating role of sleep, physical activity and circadian rhythms in the well-established associations of the atypical MDD subtype with Body Mass Index (BMI) and the metabolic syndrome (MeS). The sample consisted of 2317 participants recruited from an urban area, who underwent comprehensive somatic and psychiatric evaluations. MDD and its subtypes were assessed via semi-structured diagnostic interviews. Sleep, physical activity and circadian rhythms were measured using actigraphy. MDD and its subtypes were associated with several actigraphy-derived variables, including later sleep midpoint, low physical activity, low inter-daily stability and larger intra-individual variability of sleep duration and relative amplitude. Sleep midpoint and physical activity fulfilled criteria for partial mediation of the association between atypical MDD and BMI, and physical activity also for partial mediation of the association between atypical MDD and MeS. Our findings confirm associations of MDD and its atypical subtype with sleep and physical activity, which are likely to partially mediate the associations of atypical MDD with BMI and MeS, although most of these associations are not explained by sleep and activity variables. This highlights the need to consider atypical MDD, sleep and sedentary behavior as cardiovascular risk factors.
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Affiliation(s)
- Jennifer Glaus
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
| | - Sun Jung Kang
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA
| | - Wei Guo
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA
| | - Femke Lamers
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelalaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
| | - Marie-Pierre F Strippoli
- Center for Research in Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Andrew Leroux
- Department of Biostatistics and Informatics, University of Colorado, Anshutz Medical Campus, Aurora, CO, USA
| | - Debangan Dey
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA
| | - Kerstin J Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Julien Vaucher
- Department of Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Peter Vollenweider
- Department of Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vadim Zipunnikov
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA
| | - Martin Preisig
- Center for Research in Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
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9
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Koumoula A, Marchionatti LE, Caye A, Karagiorga VE, Balikou P, Lontou K, Arkoulaki V, Simioni A, Serdari A, Kotsis K, Basta M, Kapsimali E, Mitropoulou A, Klavdianou N, Zeleni D, Mitroulaki S, Botzaki A, Gerostergios G, Samiotakis G, Moschos G, Giannopoulou I, Papanikolaou K, Aggeli K, Scarmeas N, Koulouvaris P, Emanuele J, Schuster K, Karyotaki E, Kalikow L, Pronoiti K, Gosmann NP, Schafer JL, Merikangas KR, Szatmari P, Cuijpers P, Georgiades K, Milham MP, Corcoran M, Burke S, Koplewicz H, Salum GA. The science of child and adolescent mental health in Greece: a nationwide systematic review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02213-9. [PMID: 37179505 DOI: 10.1007/s00787-023-02213-9] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/11/2023] [Indexed: 05/15/2023]
Abstract
Evidence-based information is essential for effective mental health care, yet the extent and accessibility of the scientific literature are critical barriers for professionals and policymakers. To map the necessities and make validated resources accessible, we undertook a systematic review of scientific evidence on child and adolescent mental health in Greece encompassing three research topics: prevalence estimates, assessment instruments, and interventions. We searched Pubmed, Web of Science, PsycINFO, Google Scholar, and IATPOTEK from inception to December 16th, 2021. We included studies assessing the prevalence of conditions, reporting data on assessment tools, and experimental interventions. For each area, manuals informed data extraction and the methodological quality were ascertained using validated tools. This review was registered in protocols.io [68583]. We included 104 studies reporting 533 prevalence estimates, 223 studies informing data on 261 assessment instruments, and 34 intervention studies. We report the prevalence of conditions according to regions within the country. A repository of locally validated instruments and their psychometrics was compiled. An overview of interventions provided data on their effectiveness. The outcomes are made available in an interactive resource online [ https://rpubs.com/camhi/sysrev_table ]. Scientific evidence on child and adolescent mental health in Greece has now been cataloged and appraised. This timely and accessible compendium of up-to-date evidence offers valuable resources for clinical practice and policymaking in Greece and may encourage similar assessments in other countries.
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Affiliation(s)
- Anastasia Koumoula
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Lauro Estivalete Marchionatti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Arthur Caye
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Vasiliki Eirini Karagiorga
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Panagiota Balikou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Katerina Lontou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Vicky Arkoulaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - André Simioni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Aspasia Serdari
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Child and Adolescent Psychiatry, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Kotsis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Basta
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Efi Kapsimali
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Andromachi Mitropoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Nikanthi Klavdianou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Domna Zeleni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Sotiria Mitroulaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Anna Botzaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Gerostergios
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Samiotakis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Moschos
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Ioanna Giannopoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- 2nd Department of Psychiatry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Papanikolaou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Child Psychiatry, Agia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Aggeli
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Nikolaos Scarmeas
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, USA
| | - Panagiotis Koulouvaris
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Jill Emanuele
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Kenneth Schuster
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Eirini Karyotaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Clinical Neuro and Developmental Psychology, Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Lily Kalikow
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Katerina Pronoiti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Natan Pereira Gosmann
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Julia Luiza Schafer
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, USA
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Pim Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Michael P Milham
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Mimi Corcoran
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Sarah Burke
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Harold Koplewicz
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Giovanni Abrahão Salum
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA.
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA.
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
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10
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Hickie IB, Merikangas KR, Carpenter JS, Iorfino F, Scott EM, Scott J, Crouse JJ. Does circadian dysrhythmia drive the switch into high- or low-activation states in bipolar I disorder? Bipolar Disord 2023; 25:191-199. [PMID: 36661342 PMCID: PMC10947388 DOI: 10.1111/bdi.13304] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Emerging evidence suggests a role of circadian dysrhythmia in the switch between "activation" states (i.e., objective motor activity and subjective energy) in bipolar I disorder. METHODS We examined the evidence with respect to four relevant questions: (1) Are natural or environmental exposures that can disrupt circadian rhythms also related to the switch into high-/low-activation states? (2) Are circadian dysrhythmias (e.g., altered rest/activity rhythms) associated with the switch into activation states in bipolar disorder? (3) Do interventions that affect the circadian system also affect activation states? (4) Are associations between circadian dysrhythmias and activation states influenced by other "third" factors? RESULTS Factors that naturally or experimentally alter circadian rhythms (e.g., light exposure) have been shown to relate to activation states; however future studies need to measure circadian rhythms contemporaneously with these natural/experimental factors. Actigraphic measures of circadian dysrhythmias are associated prospectively with the switch into high- or low-activation states, and more studies are needed to establish the most relevant prognostic actigraphy metrics in bipolar disorder. Interventions that can affect the circadian system (e.g., light therapy, lithium) can also reduce the switch into high-/low-activation states. Whether circadian rhythms mediate these clinical effects is an unknown but valuable question. The influence of age, sex, and other confounders on these associations needs to be better characterised. CONCLUSION Based on the reviewed evidence, our view is that circadian dysrhythmia is a plausible driver of transitions into high- and low-activation states and deserves prioritisation in research in bipolar disorders.
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Affiliation(s)
- Ian B. Hickie
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
| | - Kathleen R. Merikangas
- Genetic Epidemiology Research Branch, Division of Intramural Research ProgramNational Institute of Mental HealthBethesdaMarylandUSA
| | - Joanne S. Carpenter
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
| | - Frank Iorfino
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
| | - Elizabeth M. Scott
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
| | - Jan Scott
- Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneUK
- Norwegian University of Science and TechnologyTrondheimNorway
- Université de ParisParisFrance
| | - Jacob J. Crouse
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
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11
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Conway KP, Bhardwaj K, Michel E, Paksarian D, Nikolaidis A, Kang M, Merikangas KR, Milham MP. Association between COVID-19 risk-mitigation behaviors and specific mental disorders in youth. Child Adolesc Psychiatry Ment Health 2023; 17:14. [PMID: 36694157 PMCID: PMC9872749 DOI: 10.1186/s13034-023-00561-7] [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: 09/02/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Although studies of adults show that pre-existing mental disorders increase risk for COVID-19 infection and severity, there is limited information about this association among youth. Mental disorders in general as well as specific types of disorders may influence the ability to comply with risk-mitigation strategies to reduce COVID-19 infection and transmission. METHODS Youth compliance (rated as "Never," "Sometimes," "Often," or "Very often/Always") with risk mitigation was reported by parents on the CoRonavIruS Health Impact Survey (CRISIS) in January 2021. The sample comprised 314 female and 514 male participants from the large-scale Child Mind Institute Healthy Brain Network, a transdiagnostic self-referred, community sample of children and adolescents (ages 5-21). Responses were summarized using factor analysis of risk mitigation, and their associations with lifetime mental disorders (assessed via structured diagnostic interviews) were identified with linear regression analyses (adjusted for covariates). All analyses used R Project for Statistical Computing for Mac (v.4.0.5). RESULTS A two-factor model was the best-fitting solution. Factor 1 (avoidance behaviors) included avoiding groups, indoor settings, and other peoples' homes; avoidance scores were higher among youth with any anxiety disorder (p = .01). Factor 2 (hygiene behaviors) included using hand sanitizer, washing hands, and maintaining social distance; hygiene scores were lower among youth with ADHD (combined type) (p = .02). Mask wearing was common (90%), did not load on either factor, and was not associated with any mental health disorder. CONCLUSION AND RELEVANCE Although most mental disorders examined were not associated with risk mitigation, youth with ADHD characterized by hyperactivity plus inattention may need additional support to consistently engage in risk-mitigation behaviors. Enhancing risk-mitigation strategies among at-risk groups of youth may help reduce COVID-19 infection and transmission.
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Affiliation(s)
- Kevin P. Conway
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, National Institute of Mental Health, 35 Convent Drive, Building 35A, Bethesda, MD 20892-3720 USA
| | - Kriti Bhardwaj
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, The Child Mind Institute, New York, NY USA
| | - Emmanuella Michel
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, National Institute of Mental Health, 35 Convent Drive, Building 35A, Bethesda, MD 20892-3720 USA
| | - Diana Paksarian
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, National Institute of Mental Health, 35 Convent Drive, Building 35A, Bethesda, MD 20892-3720 USA
| | - Aki Nikolaidis
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, The Child Mind Institute, New York, NY USA
| | - Minji Kang
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, The Child Mind Institute, New York, NY USA
| | - Kathleen R. Merikangas
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, National Institute of Mental Health, 35 Convent Drive, Building 35A, Bethesda, MD 20892-3720 USA
| | - Michael P. Milham
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, The Child Mind Institute, New York, NY USA ,grid.250263.00000 0001 2189 4777Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY USA
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12
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Difrancesco S, Penninx BW, Merikangas KR, van Hemert AM, Riese H, Lamers F. Within-day bidirectional associations between physical activity and affect: A real-time ambulatory study in persons with and without depressive and anxiety disorders. Depress Anxiety 2022; 39:922-931. [PMID: 36345264 PMCID: PMC9729402 DOI: 10.1002/da.23298] [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: 03/27/2022] [Revised: 10/25/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Ambulatory assessments offer opportunities to study physical activity level (PAL) and affect at the group and person-level. We examined bidirectional associations between PAL and affect in a 3-h timeframe and evaluated whether associations differ between people with and without current or remitted depression/anxiety. METHODS Two-week ecological momentary assessment (EMA) and actigraphy data of 359 participants with current (n = 93), remitted (n = 176), or no (n = 90) Composite International Diagnostic Interview depression/anxiety diagnoses were obtained from the Netherlands Study of Depression and Anxiety. Positive affect (PA) and negative affect (NA) were assessed by EMA 5 times per day. Average PAL between EMA assessments were calculated from actigraphy data. RESULTS At the group-level, higher PAL was associated with subsequent higher PA (b = 0.109, p < .001) and lower NA (b = -0.043, p < .001), while higher PA (b = 0.066, p < .001) and lower NA (b = -0.053, p < .001) were associated with subsequent higher PAL. The association between higher PAL and subsequent lower NA was stronger for current depression/anxiety patients than controls (p = .01). At the person-level, analyses revealed heterogeneity in bidirectional associations. CONCLUSIONS Higher PAL may improve affect, especially among depression/anxiety patients. As the relationships vary at the person-level, ambulatory assessments may help identify who would benefit from behavioral interventions.
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Affiliation(s)
- Sonia Difrancesco
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands,Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
| | - Brenda W.J.H. Penninx
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands,Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
| | - Kathleen R Merikangas
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda MD, USA
| | - Albert M. van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Harriëtte Riese
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - Femke Lamers
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, The Netherlands,Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
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13
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Zhang J, Merikangas KR, Li H, Shou H. TWO-SAMPLE TESTS FOR MULTIVARIATE REPEATED MEASUREMENTS OF HISTOGRAM OBJECTS WITH APPLICATIONS TO WEARABLE DEVICE DATA. Ann Appl Stat 2022; 16:2396-2416. [PMID: 38037595 PMCID: PMC10688324 DOI: 10.1214/21-aoas1596] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Repeated observations have become increasingly common in biomedical research and longitudinal studies. For instance, wearable sensor devices are deployed to continuously track physiological and biological signals from each individual over multiple days. It remains of great interest to appropriately evaluate how the daily distribution of biosignals might differ across disease groups and demographics. Hence, these data could be formulated as multivariate complex object data, such as probability densities, histograms, and observations on a tree. Traditional statistical methods would often fail to apply, as they are sampled from an arbitrary non-Euclidean metric space. In this paper we propose novel, nonparametric, graph-based two-sample tests for object data with the same structure of repeated measures. We treat the repeatedly measured object data as multivariate object data, which requires the same number of repeated observations per individual but eliminates any assumptions on the errors of the repeated observations. A set of test statistics are proposed to capture various possible alternatives. We derive their asymptotic null distributions under the permutation null. These tests exhibit substantial power improvements over the existing methods while controlling the type I errors under finite samples as shown through simulation studies. The proposed tests are demonstrated to provide additional insights on the location, inter- and intra-individual variability of the daily physical activity distributions in a sample of studies for mood disorders.
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Affiliation(s)
- Jingru Zhang
- Division of Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine
| | - Kathleen R. Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, National Institutes of Health
| | - Hongzhe Li
- Division of Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine
| | - Haochang Shou
- Division of Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine
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14
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Hirota T, Paksarian D, He JP, Inoue S, Stapp EK, Van Meter A, Merikangas KR. Associations of Social Capital with Mental Disorder Prevalence, Severity, and Comorbidity among U.S. Adolescents. J Clin Child Adolesc Psychol 2022; 51:970-981. [PMID: 33656940 PMCID: PMC8413396 DOI: 10.1080/15374416.2021.1875326] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To examine cross-sectional associations between social capital constructs and 1) adolescent lifetime mental disorders, 2) severity of functional impairment, and 3) psychiatric comorbidity. METHOD Data were from the National Comorbidity Survey Adolescent Supplement, a nationally representative mental health survey of 6,483 U.S. adolescents aged 13-18 years. Information from fully-structured diagnostic interviews, including adolescent and caregiver reports, was used to measure seven social capital constructs and lifetime DSM-IV mental disorders (mood, anxiety, behavior, substance use and eating disorder classes). Disorder severity was divided into severe vs. mild/moderate. Comorbidity was measured as the number of different classes of lifetime mental disorders. RESULTS Adjusted for socio-demographics and caregivers' mental health, the most consistent associations with adolescent mental disorder were for supportive friendships (any disorder OR = 0.95, 95%CI = 0.91-0.99), family cohesion (OR = 0.81, 95%CI = 0.75-0.86), school bonding (OR = 0.76, 95%CI = 0.71-0.81), and extracurricular participation (OR = 0.90, 95%CI = 0.86-0.95), although results differed by disorder class. Caregiver-reported neighborhood trust and reciprocity and caregiver community involvement were less consistently associated with mental disorder. Medium levels of adolescent-reported affiliation with neighbors was associated with lower odds of mood (OR = 0.81, 95%CI = 0.66-0.98) and anxiety (OR = 0.78, 95%CI = 0.64-0.96) disorder, while high levels were associated with higher odds of behavior disorder (OR = 1.47, 95%CI = 1.16-1.87). Several associations were stronger for severe vs. mild/moderate disorder and with increasing comorbidity. CONCLUSION Although we cannot infer causality, our findings support the notion that improving actual and/or perceived social capital, especially regarding friendships, family, and school, (e.g., through multimodal interventions) could aid in the prevention and treatment of both individual adolescent mental disorders and psychiatric comorbidity.
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Affiliation(s)
- Tomoya Hirota
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, CA, USA
| | - Diana Paksarian
- Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Jian-Ping He
- Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Sachiko Inoue
- Department of Nursing Science, Faculty of Health and Welfare Science, Okayama, Prefectural University, Soja, Okayama, Japan
| | - Emma K. Stapp
- Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Anna Van Meter
- Department of Psychiatry, Northwell Health, The Zucker Hillside Hospital, Glen Oaks, New York, USA
- Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, New York, USA
- Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, New York, USA
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15
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Conway KP, Bhardwaj K, Michel E, Paksarian D, Nikolaidis A, Kang M, Merikangas KR, Milham MP. Association between COVID-19 Risk-Mitigation Behaviors and Specific Mental Disorders in Youth. Res Sq 2022:rs.3.rs-2026969. [PMID: 36172129 PMCID: PMC9516855 DOI: 10.21203/rs.3.rs-2026969/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background : Although studies of adults show that pre-existing mental disorders increase risk for COVID-19 infection and severity, there is limited information about this association among youth. Mental disorders in general as well as specific types of disorders may influence their ability to comply with risk-mitigation strategies to reduce COVID-19 infection and transmission. Methods : Youth compliance (rated as "Never," "Sometimes," "Often," or "Very often/Always") with risk mitigation was reported by parents on the CoRonavIruS Health Impact Survey (CRISIS) in January 2021. Responses were summarized using factor analysis of risk mitigation, and their associations with lifetime mental disorders (assessed via structured diagnostic interviews) were identified with linear regression analyses (adjusted for covariates). All analyses used R Project for Statistical Computing for Mac (v.4.0.5). Results : A two-factor model was the best-fitting solution. Factor 1 (avoidance behaviors) included avoiding groups, indoor settings, and other peoples' homes; avoidance was more likely among youth with any anxiety disorder (p=.01). Factor 2 (hygiene behaviors) included using hand sanitizer, washing hands, and maintaining social distance; practicing hygiene was less likely among youth with ADHD (combined type) (p=.02). Mask wearing, which did not load on either factor, was not associated with any mental health disorder. Conclusion and Relevance : Findings suggest that education and monitoring of risk-mitigation strategies in certain subgroups of youth may reduce risk of exposure to COVID-19 and other contagious diseases. Additionally, they highlight the need for greater attention to vaccine prioritization for individuals with ADHD.
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16
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Stapp EK, Cui L, Guo W, Paksarian D, Merikangas KR. Comorbidity and familial aggregation of back/neck pain in the NIMH Family Study of Affective Spectrum Disorders. J Psychosom Res 2022; 158:110927. [PMID: 35526400 DOI: 10.1016/j.jpsychores.2022.110927] [Citation(s) in RCA: 1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Back pain is associated with substantial Global Burden of Disease and is highly comorbid with mood and anxiety symptoms and syndromes. However, mechanisms underlying this association have not been well-elucidated. Here we apply data from the NIMH Family Study of Affective Spectrum Disorders to investigate the comorbidity, familial aggregation, and cross-aggregation of back/neck pain with mood disorder subtypes. METHODS The sample includes 519 probands and 560 interviewed first-degree relatives. Lifetime DSM-IV Bipolar I, Bipolar II, and Major Depressive Disorder [MDD] were derived from semi-structured diagnostic interviews. Lifetime history of back or neck pain and its age of onset were self-reported retrospectively. Familial aggregation and cross-aggregation were estimated via mixed effects models in probands and interviewed first-degree relatives, while heritability and co-heritability (endophenotypic ranking value [ERV]) were estimated using full pedigrees. RESULTS Over 45% of participants endorsed a history of back/neck pain. Back/neck pain was familial (adjusted odds ratio [aOR] 1.5, p = 0.04; h2 = 0.24, p = 0.009). Back/neck pain in probands was associated with MDD in relatives (aOR 1.5, p = 0.04; ERV = 0.17, p = 0.024), but not with bipolar disorder. Onset of back/neck pain occurred earlier in those with bipolar disorder compared to controls. CONCLUSION Findings suggest common familial risk factors underlying back/neck pain with MDD, whereas there was within-individual comorbidity of bipolar with back/neck pain. Future studies that identify common factors that lead to either back/neck pain or MDD can inform prevention and interventions.
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Affiliation(s)
- Emma K Stapp
- Genetic Epidemiology Branch, Intramural Research Program, NIMH, Bethesda, MD, USA
| | - Lihong Cui
- Genetic Epidemiology Branch, Intramural Research Program, NIMH, Bethesda, MD, USA
| | - Wei Guo
- Genetic Epidemiology Branch, Intramural Research Program, NIMH, Bethesda, MD, USA
| | - Diana Paksarian
- Genetic Epidemiology Branch, Intramural Research Program, NIMH, Bethesda, MD, USA
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17
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Quick CR, Conway KP, Swendsen J, Stapp EK, Cui L, Merikangas KR. Comorbidity and Coaggregation of Major Depressive Disorder and Bipolar Disorder and Cannabis Use Disorder in a Controlled Family Study. JAMA Psychiatry 2022; 79:727-735. [PMID: 35648395 PMCID: PMC9161121 DOI: 10.1001/jamapsychiatry.2022.1338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 12/27/2022]
Abstract
IMPORTANCE Cannabis use disorder (CUD) is increasing in the US. Clarification of the potential mechanisms underlying the comorbidity between mood disorders and CUD may help prevent CUD. OBJECTIVE To examine co-occurrence and familial aggregation of CUD and mood disorder subtypes. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional, community-based study in the Washington, DC, metropolitan area, semistructured diagnostic interviews and family history reports assessed lifetime DSM-IV disorders in probands and relatives. Familial aggregation and coaggregation of CUD with mood disorders were estimated via mixed-effects models, adjusting for age, sex, recruitment source, and comorbid mood, anxiety, and other substance use disorders. A total of 586 adult probands (186 with bipolar disorder; 55 with CUD) and 698 first-degree relatives (91 with bipolar disorder; 68 with CUD) were recruited from a community screening of the greater Washington, DC, metropolitan area from May 2004 to August 2020. Inclusion criteria were ability to speak English, and availability and consent to contact at least 2 living first-degree relatives. MAIN OUTCOMES AND MEASURES Lifetime CUD in first-degree relatives. RESULTS Of 586 probands, 395 (67.4%) were female; among 698 relatives, 437 (62.6%) were female. The mean (SD) age was 47.5 (15.2) years for probands and 49.6 (18.0) years for relatives. In the proband group, 82 participants (14.0%) self-identified as African American or Black, 467 (79.7%) as White, and 37 (6.3%) as American Indian or Alaska Native, Asian, more than one race, or another race or ethnicity or declined to respond. In the relative group, 53 participants (7.6%) self-identified as African American or Black, 594 (85.1%) as White, and 51 (7.3%) as American Indian or Alaska Native, Asian, more than one race, or another race or ethnicity or declined to respond. These groups were combined to protect privacy owing to small numbers. CUD in probands (55 [9.4%]) was associated with an increase in CUD in relatives (adjusted odds ratio [aOR], 2.64; 95% CI, 1.20-5.79; P = .02). Bipolar disorder II (BP-II) in probands (72 [12.3%]) was also associated with increased risk of CUD in relatives (aOR, 2.57; 95% CI, 1.06-6.23; P = .04). However, bipolar disorder I (114 [19.5%]) and major depressive disorder (192 [32.8%]) in probands were not significantly associated with CUD in relatives. Among relatives, CUD was associated with BP-II (aOR, 4.50; 95% CI, 1.72-11.77; P = .002), major depressive disorder (aOR, 3.64; 95% CI, 1.78-7.45; P < .001), and mean (SD) age (42.7 [12.8] years with CUD vs 50.3 [18.3] years without CUD; aOR, 0.98; 95% CI, 0.96-1.00; P = .02). Familial coaggregation of BP-II with CUD was attenuated by the inclusion of comorbid anxiety disorders. Further, rates of CUD were highest in relatives with both a familial and individual history of BP-II (no familial or individual history of BP-II: 41 [7.2%]; familial history but no individual history of BP-II: 13 [19.1%]; individual history but no familial history of BP-II: 10 [22.2%]; familial and individual history of BP-II: 4 [28.6%]; Fisher exact test, P < .001). The onset of mood disorder subtypes preceded CUD in probands and relatives in most cases. CONCLUSIONS AND RELEVANCE The findings confirmed a familial aggregation of CUD. The increase in risk of CUD among relatives of probands with BP-II suggests that CUD may share a common underlying diathesis with BP-II. Taken together with the temporal precedence of depression and mania with respect to CUD onset, these findings highlight a potential role for BP-II intervention as CUD prevention.
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Affiliation(s)
- Courtney R. Quick
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Kevin P. Conway
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Joel Swendsen
- Aquitaine Institute for Cognitive and Integrative Neuroscience, University of Bordeaux, Bordeaux, France
| | - Emma K. Stapp
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Lihong Cui
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Kathleen R. Merikangas
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
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18
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Mazzotti DR, Haendel MA, McMurry JA, Smith CJ, Buysse DJ, Roenneberg T, Penzel T, Purcell S, Redline S, Zhang Y, Merikangas KR, Menetski JP, Mullington J, Boudreau E. Sleep and circadian informatics data harmonization: a workshop report from the Sleep Research Society and Sleep Research Network. Sleep 2022; 45:zsac002. [PMID: 35030631 PMCID: PMC9189941 DOI: 10.1093/sleep/zsac002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/12/2021] [Revised: 12/21/2021] [Indexed: 01/16/2023] Open
Abstract
The increasing availability and complexity of sleep and circadian data are equally exciting and challenging. The field is in constant technological development, generating better high-resolution physiological and molecular data than ever before. Yet, the promise of large-scale studies leveraging millions of patients is limited by suboptimal approaches for data sharing and interoperability. As a result, integration of valuable clinical and basic resources is problematic, preventing knowledge discovery and rapid translation of findings into clinical care. To understand the current data landscape in the sleep and circadian domains, the Sleep Research Society (SRS) and the Sleep Research Network (now a task force of the SRS) organized a workshop on informatics and data harmonization, presented at the World Sleep Congress 2019, in Vancouver, Canada. Experts in translational informatics gathered with sleep research experts to discuss opportunities and challenges in defining strategies for data harmonization. The goal of this workshop was to fuel discussion and foster innovative approaches for data integration and development of informatics infrastructure supporting multi-site collaboration. Key recommendations included collecting and storing findable, accessible, interoperable, and reusable data; identifying existing international cohorts and resources supporting research in sleep and circadian biology; and defining the most relevant sleep data elements and associated metadata that could be supported by early integration initiatives. This report introduces foundational concepts with the goal of facilitating engagement between the sleep/circadian and informatics communities and is a call to action for the implementation and adoption of data harmonization strategies in this domain.
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Affiliation(s)
- Diego R Mazzotti
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Melissa A Haendel
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Julie A McMurry
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Connor J Smith
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA,USA
| | - Till Roenneberg
- Institute and Polyclinic for Occupational-, Social- and Environmental Medicine, LMU Munich, Germany
| | - Thomas Penzel
- Interdisciplinary Center of Sleep Medicine, Charité University Hospital, Berlin, Germany
| | - Shaun Purcell
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Ying Zhang
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | | | - Janet Mullington
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Eilis Boudreau
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
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19
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Moulin F, Gholam M, Strippoli MPF, Castelao E, Merikangas KR, Stapp EK, Marquet P, Aubry JM, Plessen KJ, Di Giacomo F, Glaus J, Pistis G, Lavigne B, Elowe J, Ranjbar S, Preisig M, Vandeleur CL. Environmental factors in offspring of parents with mood disorders and their role in parent-child transmission: findings from a 14-year prospective high-risk study. Int J Bipolar Disord 2022; 10:11. [PMID: 35386056 PMCID: PMC8986929 DOI: 10.1186/s40345-022-00257-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background The factors involved in the transmission of mood disorders are only partially elucidated. Aside from genes, the family environment might play a crucial role in parent–child transmission. Our goals were to (1) assess the associations of parental bipolar disorder (BPD) and Major Depressive Disorder (MDD) with individual or shared family environmental factors, including traumatic events in offspring, parental separation, family cohesion and parental attitudes; and 2) test whether these factors were mediators of the association between exposure to parental mood disorders and the onset of these disorders in offspring. Methods The sample stems from an ongoing family high-risk study of mood disorders conducted in the French-speaking part of Switzerland. Given the strong impact of the age of onset of parental disorders on their transmission to children, parental disorders were dichotomized according to the onset (cut-off 21 years). Probands with early-onset (n = 30) and later-onset BPD (n = 51), early-onset (n = 21) and later-onset MDD (n = 47) and controls (n = 65), along with their spouses (n = 193) and offspring (n = 388; < 18 years on study inclusion), were assessed over a mean follow-up duration of 14 years (s.d: 4.6). The environmental measures were based on reports by offspring collected before the onset of their first mood episode. Results Offspring of probands with later-onset BPD and offspring of probands with both early-onset and later-onset MDD reported traumatic events more frequently than comparison offspring, whereas exposure to parental separation was more frequent in all groups of high-risk offspring. Moreover, several familial environment scores including parenting attitudes differed between offspring of probands with BPD and comparison offspring. However, none of these factors were mediators of the parent–child transmission of BPD. Among the environmental factors, traumatic events were shown to be modest mediators of the transmission of early-onset MDD. Conclusions Our data do not support the implication of the assessed environmental factors in the parent–child transmission of BPD. In contrast to BPD, traumatic events partially mediate the parent–child transmission of early-onset MDD, which has important implications for intervention and prevention. Early therapeutic efforts in offspring exposed to these events are likely to reduce their deleterious impact on the risk of subsequent MDD.
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Affiliation(s)
- Flore Moulin
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland.,INSERM U 1219, Bordeaux Population Health Research Center, Bordeaux, France
| | - Mehdi Gholam
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Marie-Pierre F Strippoli
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Emma K Stapp
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Pierre Marquet
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,International Research Unit in Neurodevelopment and Child Psychiatry, Laval University, Quebec, Canada
| | - Jean-Michel Aubry
- Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - Kerstin J Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Francesca Di Giacomo
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, North Sector, Canton of Vaud, Yverdon, Switzerland
| | - Jennifer Glaus
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Giorgio Pistis
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Benjamin Lavigne
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, West Sector, Canton of Vaud, Prangins, Switzerland
| | - Julien Elowe
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, North and West Sectors, Canton of Vaud, Yverdon and Prangins, Switzerland
| | - Setareh Ranjbar
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Caroline L Vandeleur
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland.
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20
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Conway KP, Bhardwaj K, Michel E, Paksarian D, Nikolaidis A, Kang M, Merikangas KR, Milham MP. Association between COVID-19 Risk-Mitigation Behaviors and Specific Mental Disorders in Youth. medRxiv 2022:2022.03.03.22271787. [PMID: 35291296 PMCID: PMC8923118 DOI: 10.1101/2022.03.03.22271787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Importance Although studies of adults show that pre-existing mental disorders increase risk for COVID-19 infection and severity, there is limited information about this association among youth. Mental disorders in general as well as specific types of disorders may influence their ability to comply with risk-mitigation strategies to reduce COVID-19 infection and transmission. Objective To examine associations between specific mental disorders and COVID-19 risk-mitigation practices among 314 female and 514 male youth. Design Youth compliance (rated as "Never," "Sometimes," "Often," or "Very often/Always") with risk mitigation was reported by parents on the CoRonavIruS Health Impact Survey (CRISIS) in January 2021. Responses were summarized using factor analysis of risk mitigation, and their associations with lifetime mental disorders (assessed via structured diagnostic interviews) were identified with linear regression analyses (adjusted for covariates). All analyses used R Project for Statistical Computing for Mac (v.4.0.5). Setting The Healthy Brain Network (HBN) in New York City Participants. 314 female and 514 male youth (ages 5-21). Main Outcomes and Measures COVID-19 risk mitigation behaviors among youth. Results A two-factor model was the best-fitting solution. Factor 1 (avoidance behaviors) included avoiding groups, indoor settings, and other peoples' homes; avoidance was more likely among youth with any anxiety disorder (p=.01). Factor 2 (hygiene behaviors) included using hand sanitizer, washing hands, and maintaining social distance; practicing hygiene was less likely among youth with ADHD (combined type) (p=.02). Mask wearing, which did not load on either factor, was not associated with any mental health disorder. Conclusion and Relevance Findings suggest that education and monitoring of risk-mitigation strategies in certain subgroups of youth may reduce risk of exposure to COVID-19 and other contagious diseases. Additionally, they highlight the need for greater attention to vaccine prioritization for individuals with ADHD. Key Points Question: Are mental disorders among youth associated with COVID-19 risk-mitigation behaviors?Findings: Based on the parent CoRonavIruS Health Impact Survey (CRISIS) of 314 females and 514 males aged 5-21, youth with anxiety disorders were more likely to avoid high-risk exposure settings, and those with ADHD (combined type) were less likely to follow hygiene practices. In contrast, mask wearing was not associated with youth mental disorders.Meaning: Specific types of disorders in youth may interfere with their ability to employ risk-mitigation strategies that may lead to greater susceptibility to COVID-19.
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Affiliation(s)
- Kevin P Conway
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Kriti Bhardwaj
- Center for the Developing Brain, The Child Mind Institute, New York, NY, USA
| | - Emmanuella Michel
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Diana Paksarian
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
- New York State Office of Mental Health, Albany, NY, USA
| | - Aki Nikolaidis
- Center for the Developing Brain, The Child Mind Institute, New York, NY, USA
| | - Minji Kang
- Center for the Developing Brain, The Child Mind Institute, New York, NY, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Michael P Milham
- Center for the Developing Brain, The Child Mind Institute, New York, NY, USA
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21
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Stapp EK, Paksarian D, He JP, Glaus J, Conway KP, Merikangas KR. Mood and anxiety profiles differentially associate with physical conditions in US adolescents. J Affect Disord 2022; 299:22-30. [PMID: 34838604 DOI: 10.1016/j.jad.2021.11.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 09/29/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Mood and anxiety are widely associated with physical conditions, but research and treatment are complicated by their overlap, clinical heterogeneity, and manifestation on a spectrum rather than as discrete disorders. In contrast to previous work relying on threshold-level disorders, we examined the association between empirically-derived profiles of mood and anxiety syndromes with physical conditions in a nationally-representative sample of US adolescents. METHODS Participants were 2,911 adolescents (aged 13-18) from the National Comorbidity Survey-Adolescent Supplement who provided information on physical conditions and reported at least one lifetime mood-anxiety 'syndrome' based on direct interviews with the Composite International Diagnostic Interview Version 3.0. Mood-anxiety syndromes reflected 3-level ratings from subthreshold to severe distress/impairment, and subtyped mood episodes. Stepwise latent profile analysis identified mood-anxiety profiles and tested associations with physical conditions. RESULTS Three mood-anxiety profiles were identified: "Mood-GAD" (25.6%)-non-atypical depression, mania, generalized anxiety; "Atypical-Panic" (11.3%)-atypical depression, panic; and "Reference" (63.1%)-lower mood and anxiety except specific phobia. Headaches were more prevalent in Mood-GAD and Atypical-Panic than Reference (47.9%, 50.1%, and 37.7%, respectively; p=0.011). Heart problems were more common in Mood-GAD than Atypical-Panic (7.4% v 2.2%, p=0.004) and Reference, with back/neck pain more prevalent in Mood-GAD than Reference (22.5% v 15.3%, p=0.016). LIMITATIONS Broad categories of physical conditions without information on specific diagnoses; replication regarding specificity is recommended. CONCLUSIONS Heart problems and pain-related conditions were differentially associated with specific mood-anxiety profiles. Subtyping depression and anxiety-inclusive of subthreshold syndromes-and their patterns of clustering may facilitate etiologic and intervention work in multimorbidity.
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Affiliation(s)
- Emma K Stapp
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Diana Paksarian
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Jian-Ping He
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Jennifer Glaus
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Kevin P Conway
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA.
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22
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Panchal P, de Queiroz Campos G, Goldman DA, Auerbach RP, Merikangas KR, Swartz HA, Sankar A, Blumberg HP. Toward a Digital Future in Bipolar Disorder Assessment: A Systematic Review of Disruptions in the Rest-Activity Cycle as Measured by Actigraphy. Front Psychiatry 2022; 13:780726. [PMID: 35677875 PMCID: PMC9167949 DOI: 10.3389/fpsyt.2022.780726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Disruptions in rest and activity patterns are core features of bipolar disorder (BD). However, previous methods have been limited in fully characterizing the patterns. There is still a need to capture dysfunction in daily activity as well as rest patterns in order to more holistically understand the nature of 24-h rhythms in BD. Recent developments in the standardization, processing, and analyses of wearable digital actigraphy devices are advancing longitudinal investigation of rest-activity patterns in real time. The current systematic review aimed to summarize the literature on actigraphy measures of rest-activity patterns in BD to inform the future use of this technology. METHODS A comprehensive systematic review using PRISMA guidelines was conducted through PubMed, MEDLINE, PsycINFO, and EMBASE databases, for papers published up to February 2021. Relevant articles utilizing actigraphy measures were extracted and summarized. These papers contributed to three research areas addressed, pertaining to the nature of rest-activity patterns in BD, and the effects of therapeutic interventions on these patterns. RESULTS Seventy articles were included. BD was associated with longer sleep onset latency and duration, particularly during depressive episodes and with predictive value for worsening of future manic symptoms. Lower overall daily activity was also associated with BD, especially during depressive episodes, while more variable activity patterns within a day were seen in mania. A small number of studies linked these disruptions with differential patterns of brain functioning and cognitive impairments, as well as more adverse outcomes including increased suicide risk. The stabilizing effect of therapeutic options, including pharmacotherapies and chronotherapies, on activity patterns was supported. CONCLUSION The use of actigraphy provides valuable information about rest-activity patterns in BD. Although results suggest that variability in rhythms over time may be a specific feature of BD, definitive conclusions are limited by the small number of studies assessing longitudinal changes over days. Thus, there is an urgent need to extend this work to examine patterns of rhythmicity and regularity in BD. Actigraphy research holds great promise to identify a much-needed specific phenotypic marker for BD that will aid in the development of improved detection, treatment, and prevention options.
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Affiliation(s)
- Priyanka Panchal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Danielle A Goldman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, United States
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, United States
| | - Holly A Swartz
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Anjali Sankar
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Department of Radiology and Biomedical Imaging, and the Child Study Center, Yale School of Medicine, New Haven, CT, United States
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23
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Klein A, Clucas J, Krishnakumar A, Ghosh SS, Van Auken W, Thonet B, Sabram I, Acuna N, Keshavan A, Rossiter H, Xiao Y, Semenuta S, Badioli A, Konishcheva K, Abraham SA, Alexander LM, Merikangas KR, Swendsen J, Lindner AB, Milham MP. Remote Digital Psychiatry for Mobile Mental Health Assessment and Therapy: MindLogger Platform Development Study. J Med Internet Res 2021; 23:e22369. [PMID: 34762054 PMCID: PMC8663601 DOI: 10.2196/22369] [Citation(s) in RCA: 8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/03/2021] [Accepted: 03/16/2021] [Indexed: 01/23/2023] Open
Abstract
Background Universal access to assessment and treatment of mental health and learning disorders remains a significant and unmet need. There are many people without access to care because of economic, geographic, and cultural barriers, as well as the limited availability of clinical experts who could help advance our understanding and treatment of mental health. Objective This study aims to create an open, configurable software platform to build clinical measures, mobile assessments, tasks, and interventions without programming expertise. Specifically, our primary requirements include an administrator interface for creating and scheduling recurring and customized questionnaires where end users receive and respond to scheduled notifications via an iOS or Android app on a mobile device. Such a platform would help relieve overwhelmed health systems and empower remote and disadvantaged subgroups in need of accurate and effective information, assessment, and care. This platform has the potential to advance scientific research by supporting the collection of data with instruments tailored to specific scientific questions from large, distributed, and diverse populations. Methods We searched for products that satisfy these requirements. We designed and developed a new software platform called MindLogger, which exceeds the requirements. To demonstrate the platform’s configurability, we built multiple applets (collections of activities) within the MindLogger mobile app and deployed several of them, including a comprehensive set of assessments underway in a large-scale, longitudinal mental health study. Results Of the hundreds of products we researched, we found 10 that met our primary requirements with 4 that support end-to-end encryption, 2 that enable restricted access to individual users’ data, 1 that provides open-source software, and none that satisfy all three. We compared features related to information presentation and data capture capabilities; privacy and security; and access to the product, code, and data. We successfully built MindLogger mobile and web applications, as well as web browser–based tools for building and editing new applets and for administering them to end users. MindLogger has end-to-end encryption, enables restricted access, is open source, and supports a variety of data collection features. One applet is currently collecting data from children and adolescents in our mental health study, and other applets are in different stages of testing and deployment for use in clinical and research settings. Conclusions We demonstrated the flexibility and applicability of the MindLogger platform through its deployment in a large-scale, longitudinal, mobile mental health study and by building a variety of other mental health–related applets. With this release, we encourage a broad range of users to apply the MindLogger platform to create and test applets to advance health care and scientific research. We hope that increasing the availability of applets designed to assess and administer interventions will facilitate access to health care in the general population.
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Affiliation(s)
- Arno Klein
- MATTER Lab, Child Mind Institute, New York, NY, United States
| | - Jon Clucas
- MATTER Lab, Child Mind Institute, New York, NY, United States.,Computational Neuroimaging Lab, Child Mind Institute, New York, NY, United States
| | - Anirudh Krishnakumar
- MATTER Lab, Child Mind Institute, New York, NY, United States.,Université de Paris and INSERM U1284 SEED unit, Centre for Research and Interdisciplinarity (CRI), Paris, France.,ETH Library Lab, ETH Zurich and Citizen Science Centre, Zurich, Switzerland
| | - Satrajit S Ghosh
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Cambridge, MA, United States
| | | | - Benjamin Thonet
- MATTER Lab, Child Mind Institute, New York, NY, United States.,Université de Paris and INSERM U1284 SEED unit, Centre for Research and Interdisciplinarity (CRI), Paris, France
| | - Ihor Sabram
- MATTER Lab, Child Mind Institute, New York, NY, United States
| | - Nino Acuna
- MATTER Lab, Child Mind Institute, New York, NY, United States
| | - Anisha Keshavan
- MATTER Lab, Child Mind Institute, New York, NY, United States.,Octave Bioscience, Menlo Park, CA, United States
| | - Henry Rossiter
- Computational Engineering, University of Texas at Austin, Austin, TX, United States
| | - Yao Xiao
- Center for the Developing Brain, Child Mind Institute, New York, NY, United States
| | - Sergey Semenuta
- MATTER Lab, Child Mind Institute, New York, NY, United States
| | | | - Kseniia Konishcheva
- MATTER Lab, Child Mind Institute, New York, NY, United States.,Université de Paris and INSERM U1284 SEED unit, Centre for Research and Interdisciplinarity (CRI), Paris, France
| | - Sanu Ann Abraham
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Lindsay M Alexander
- Center for the Developing Brain, Child Mind Institute, New York, NY, United States
| | | | - Joel Swendsen
- National Center for Scientific Research, University of Bordeaux, EPHE PSL University, Bordeaux, France
| | - Ariel B Lindner
- Université de Paris and INSERM U1284 SEED unit, Centre for Research and Interdisciplinarity (CRI), Paris, France
| | - Michael P Milham
- Center for the Developing Brain, Child Mind Institute, New York, NY, United States.,Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States
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24
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O’Callaghan VS, Hansell NK, Guo W, Carpenter JS, Shou H, Strike LT, Crouse JJ, McAloney K, McMahon KL, Byrne EM, Burns JM, Martin NG, Hickie IB, Merikangas KR, Wright MJ. Genetic and environmental influences on sleep-wake behaviors in adolescence. Sleep Adv 2021; 2:zpab018. [PMID: 37193570 PMCID: PMC10104400 DOI: 10.1093/sleepadvances/zpab018] [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] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/23/2021] [Indexed: 05/18/2023]
Abstract
Study Objectives To investigate the influence of genetic and environmental factors on sleep-wake behaviors across adolescence. Methods Four hundred and ninety-five participants (aged 9-17; 55% females), including 93 monozygotic and 117 dizygotic twin pairs, and 75 unmatched twins, wore an accelerometry device and completed a sleep diary for 2 weeks. Results Individual differences in sleep onset, wake time, and sleep midpoint were influenced by both additive genetic (44%-50% of total variance) and shared environmental (31%-42%) factors, with a predominant genetic influence for sleep duration (62%) and restorative sleep (43%). When stratified into younger (aged 9-14) and older (aged 16-17) subsamples, genetic sources were more prominent in older adolescents. The moderate correlation between sleep duration and midpoint (rP = -.43, rG = .54) was attributable to a common genetic source. Sleep-wake behaviors on school and nonschool nights were correlated (rP = .44-.72) and influenced by the same genetic and unique environmental factors. Genetic sources specific to night-type were also identified, for all behaviors except restorative sleep. Conclusions There were strong genetic influences on sleep-wake phenotypes, particularly on sleep timing, in adolescence. Moreover, there may be common genetic influences underlying both sleep and circadian rhythms. The differences in sleep-wake behaviors on school and nonschool nights could be attributable to genetic factors involved in reactivity to environmental context.
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Affiliation(s)
| | - Narelle K Hansell
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Wei Guo
- Genetic Epidemiology Branch, National Institute of Mental Health, National Institutes of HealthBethesda, MD, USA
| | | | - Haochang Shou
- Genetic Epidemiology Branch, National Institute of Mental Health, National Institutes of HealthBethesda, MD, USA
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Lachlan T Strike
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Jacob J Crouse
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Kerrie McAloney
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Enda M Byrne
- Institute of Molecular Bioscience, University of Queensland, Brisbane, Australia
- Child Health Research Centre, University of Queensland, Brisbane, Australia
| | - Jane M Burns
- Young and Well Cooperative Research Centre, Melbourne, Australia
| | | | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Kathleen R Merikangas
- Genetic Epidemiology Branch, National Institute of Mental Health, National Institutes of HealthBethesda, MD, USA
| | - Margaret J Wright
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
- Centre for Advanced Imaging, University of Queensland, Brisbane, Australia
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25
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Crouse JJ, Carpenter JS, Song YJC, Hockey SJ, Naismith SL, Grunstein RR, Scott EM, Merikangas KR, Scott J, Hickie IB. Circadian rhythm sleep-wake disturbances and depression in young people: implications for prevention and early intervention. Lancet Psychiatry 2021; 8:813-823. [PMID: 34419186 DOI: 10.1016/s2215-0366(21)00034-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [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: 11/24/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/19/2022]
Abstract
A rate-limiting step in the prevention and early intervention of depressive disorders in young people is our insufficient understanding of causal mechanisms. One plausible pathophysiological pathway is disturbance in the 24 h sleep-wake cycle and the underlying circadian system. Abnormalities in circadian rhythms are well documented in adults with various depressive disorders and have been linked to core clinical features, including unstable mood, daytime fatigue, non-restorative sleep, reduced motor activity, somatic symptoms, and appetite and weight change. In this Review, we summarise four areas of research: basic circadian biology and animal models of circadian disturbances; developmental changes in circadian rhythms during adolescence and implications for the emergence of adolescent-onset depressive syndromes; community and clinical studies linking 24 h sleep-wake cycle disturbances and depressive disorders; and clinical trials of circadian-based treatments. We present recommendations based on a highly personalised, early intervention model for circadian-linked depression in young people.
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Affiliation(s)
- Jacob J Crouse
- Youth Mental Health and Technology Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
| | - Joanne S Carpenter
- Youth Mental Health and Technology Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Yun Ju C Song
- Youth Mental Health and Technology Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Samuel J Hockey
- Youth Mental Health and Technology Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Ronald R Grunstein
- Woolcock Institute of Medical Research, Sleep and Circadian Research Group, Sydney, NSW, Australia
| | - Elizabeth M Scott
- St Vincent's and Mater Clinical School, The University of Notre Dame, Sydney, NSW, Australia
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Division of Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Jan Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Ian B Hickie
- Youth Mental Health and Technology Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
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26
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Horowitz LM, Wharff EA, Mournet AM, Ross AM, McBee-Strayer S, He JP, Lanzillo EC, White E, Bergdoll E, Powell DS, Solages M, Merikangas KR, Pao M, Bridge JA. Validation and Feasibility of the ASQ Among Pediatric Medical and Surgical Inpatients. Hosp Pediatr 2021; 10:750-757. [PMID: 32826283 DOI: 10.1542/hpeds.2020-0087] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To validate the use of a brief suicide risk screening tool, the Ask Suicide-Screening Questions (ASQ) instrument, in pediatric inpatient medical and surgical settings. METHODS Pediatric patients (10-21 years) hospitalized on inpatient medical and surgical units were recruited through convenience sampling for participation in a cross-sectional instrument validation study. The Suicidal Ideation Questionnaire was used as a standard criterion to validate the ASQ. Patient opinions about screening and parent consent to enroll in a suicide risk screening study were assessed to determine the feasibility of administering the ASQ in this venue. RESULTS A total of 600 pediatric medical inpatients were screened. Compared with the gold standard, the ASQ had strong psychometric properties, with a sensitivity of 96.67% (95% confidence interval [CI]: 82.78 to 99.92), a specificity of 91.05% (95% CI: 88.40 to 93.27), a negative predictive value of 99.81% (95% CI: 98.93 to 99.99), and an area under curve of 0.94 (95% CI: 0.90 to 0.97). Only 3 participants (0.5%) had acute positive screen results on the ASQ, endorsing current suicidal ideation, whereas 77 participants (12.8%) screened nonacute positive, and 48 participants (8.0%) reported a past suicide attempt. CONCLUSIONS The brief 4-item ASQ is a valid tool to detect elevated suicide risk in pediatric medical and surgical inpatients. Our findings also reveal that screening is feasible in terms of detection of suicidal thoughts and behaviors and is acceptable to parents and patients.
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Affiliation(s)
| | | | | | | | - Sandra McBee-Strayer
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio
| | - Jian-Ping He
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland;
| | | | - Erina White
- Boston Children's Hospital, Boston, Massachusetts
| | - Emory Bergdoll
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio
| | | | - Martine Solages
- Children's National Hospital, Washington, District of Columbia; and
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland
| | | | - Jeffrey A Bridge
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio.,College of Medicine, The Ohio State University, Columbus, Ohio
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27
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Stapp EK, Cui L, Swendsen J, Merikangas KR. Biorhythms, Mood, And Pain In Real-time: Insights From The Nimh Family Study Of Affective Spectrum Disorders. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000762724.59882.ff] [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: 11/21/2022]
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28
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Nichles A, Zmicerevska N, Song YJC, Wilson C, McHugh C, Hamilton B, Crouse J, Rohleder C, Carpenter JS, Ho N, Hermens DF, Wray N, Scott J, Merikangas KR, Leweke FM, Koethe D, Iorfino F, Naismith SL, Guastella AJ, Scott EM, Hickie IB. Neurobiology Youth Follow-up Study: protocol to establish a longitudinal and prospective research database using multimodal assessments for current and past mental health treatment-seeking young people within an early intervention service. BMJ Open 2021; 11:e044731. [PMID: 34145010 PMCID: PMC8215251 DOI: 10.1136/bmjopen-2020-044731] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Approximately 75% of major mental illness occurs before the age of 25 years. Despite this, our capacity to provide effective, early and personalised interventions is limited by insufficient evidence for characterising early-stage, and less specific, presentations of major mental disorders in youth populations. This article describes the protocol for setting up a large-scale database that will collect longitudinal, prospective data that incorporate clinical, social and occupational function, neuropsychological, circadian, metabolic, family history and genetic metrics. By collecting data in a research-purposed, standardised manner, the 'Neurobiology Youth Follow-up Study' should improve identification, characterisation and profiling of youth attending mental healthcare, to better inform diagnosis and treatment at critical time points. The overall goal is enhanced long-term clinical and functional outcomes. METHODS AND ANALYSIS This longitudinal clinical cohort study will invite participation from youth (12-30 years) who seek help for mental health-related issues at an early intervention service (headspace Camperdown) and linked services. Participants will be prospectively tracked over 3 years with a series of standardised multimodal assessments at baseline, 6, 12, 24 and 36 months. Evaluations will include: (1) clinician-administered and self-report assessments determining clinical stage, pathophysiological pathways to illness, diagnosis, symptomatology, social and occupational function; (2) neuropsychological profile; (3) sleep-wake patterns and circadian rhythms; (4) metabolic markers and (5) genetics. These data will be used to: (1) model the impact of demographic, phenomenological and treatment variables, on clinical and functional outcomes; (2) map neurobiological profiles and changes onto a transdiagnostic clinical stage and pathophysiological mechanisms framework. ETHICS AND DISSEMINATION This study protocol has been approved by the Human Research Ethics Committee of the Sydney Local Health District (2020/ETH01272, protocol V.1.3, 14 October 2020). Research findings will be disseminated through peer-reviewed journals and presentations at scientific conferences and to user and advocacy groups. Participant data will be de-identified.
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Affiliation(s)
- Alissa Nichles
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Natalia Zmicerevska
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Chloe Wilson
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Catherine McHugh
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Blake Hamilton
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Jacob Crouse
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Cathrin Rohleder
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Nicholas Ho
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
| | - Naomi Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | - F Markus Leweke
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Dagmar Koethe
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Frank Iorfino
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Sharon L Naismith
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Adam J Guastella
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Elizabeth M Scott
- School of Medicine, The University of Notre Dame Sydney Campus, Darlinghurst, New South Wales, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
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Panchal P, Kim JA, Sankar A, Goldman D, Villa LM, Millard H, Carrubba E, Lecza B, Merikangas KR, Silverman WK, Swartz HA, Blumberg HP. Changing gears in the treatment of bipolar disorder through integrated use of electronic devices. Bipolar Disord 2021; 23:418-419. [PMID: 33638233 PMCID: PMC9587895 DOI: 10.1111/bdi.13065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/17/2021] [Accepted: 02/21/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Priyanka Panchal
- Mood Disorders Research Program, Department of Psychiatry,
Yale School of Medicine, New Haven, CT, USA
| | - Jihoon A. Kim
- Mood Disorders Research Program, Department of Psychiatry,
Yale School of Medicine, New Haven, CT, USA
| | - Anjali Sankar
- Mood Disorders Research Program, Department of Psychiatry,
Yale School of Medicine, New Haven, CT, USA
| | - Danielle Goldman
- Mood Disorders Research Program, Department of Psychiatry,
Yale School of Medicine, New Haven, CT, USA,Interdepartmental Neuroscience Program, Yale School of
Medicine, New Haven, CT, USA
| | - Luca M. Villa
- Mood Disorders Research Program, Department of Psychiatry,
Yale School of Medicine, New Haven, CT, USA
| | - Hun Millard
- Mood Disorders Research Program, Department of Psychiatry,
Yale School of Medicine, New Haven, CT, USA,Child Study Center, Yale School of Medicine, New Haven, CT,
USA
| | - Erin Carrubba
- Mood Disorders Research Program, Department of Psychiatry,
Yale School of Medicine, New Haven, CT, USA
| | - Bernadette Lecza
- Mood Disorders Research Program, Department of Psychiatry,
Yale School of Medicine, New Haven, CT, USA
| | | | | | - Holly A. Swartz
- Department of Psychiatry, University of Pittsburgh,
Pittsburgh, PA, USA
| | - Hilary P. Blumberg
- Mood Disorders Research Program, Department of Psychiatry,
Yale School of Medicine, New Haven, CT, USA,Child Study Center, Yale School of Medicine, New Haven, CT,
USA,Department of Radiology and Biomedical Imaging, Yale School
of Medicine, New Haven, CT, USA
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30
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Nikolaidis A, Paksarian D, Alexander L, Derosa J, Dunn J, Nielson DM, Droney I, Kang M, Douka I, Bromet E, Milham M, Stringaris A, Merikangas KR. The Coronavirus Health and Impact Survey (CRISIS) reveals reproducible correlates of pandemic-related mood states across the Atlantic. Sci Rep 2021; 11:8139. [PMID: 33854103 PMCID: PMC8046981 DOI: 10.1038/s41598-021-87270-3] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [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: 12/06/2020] [Accepted: 03/24/2021] [Indexed: 02/02/2023] Open
Abstract
The COVID-19 pandemic and its social and economic consequences have had adverse impacts on physical and mental health worldwide and exposed all segments of the population to protracted uncertainty and daily disruptions. The CoRonavIruS health and Impact Survey (CRISIS) was developed for use as an easy to implement and robust questionnaire covering key domains relevant to mental distress and resilience during the pandemic. Ongoing studies using CRISIS include international studies of COVID-related ill health conducted during different phases of the pandemic and follow-up studies of cohorts characterized before the COVID pandemic. In the current work, we demonstrate the feasibility, psychometric structure, and construct validity of this survey. We then show that pre-existing mood states, perceived COVID risk, and lifestyle changes are strongly associated with negative mood states during the pandemic in population samples of adults and in parents reporting on their children in the US and UK. These findings are highly reproducible and we find a high degree of consistency in the power of these factors to predict mental health during the pandemic.
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Affiliation(s)
- Aki Nikolaidis
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, The Child Mind Institute, New York, NY USA
| | - Diana Paksarian
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD USA
| | - Lindsay Alexander
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, The Child Mind Institute, New York, NY USA
| | - Jacob Derosa
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, The Child Mind Institute, New York, NY USA
| | - Julia Dunn
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD USA
| | - Dylan M. Nielson
- grid.94365.3d0000 0001 2297 5165Section On Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Irene Droney
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, The Child Mind Institute, New York, NY USA
| | - Minji Kang
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, The Child Mind Institute, New York, NY USA
| | - Ioanna Douka
- grid.94365.3d0000 0001 2297 5165Section On Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Evelyn Bromet
- grid.36425.360000 0001 2216 9681Department of Psychiatry, Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY USA
| | - Michael Milham
- grid.428122.f0000 0004 7592 9033Center for the Developing Brain, The Child Mind Institute, New York, NY USA ,grid.250263.00000 0001 2189 4777Nathan Kline Institute for Psychiatric Research, Orangeburg, NY USA
| | - Argyris Stringaris
- grid.94365.3d0000 0001 2297 5165Section On Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Kathleen R. Merikangas
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD USA ,grid.21107.350000 0001 2171 9311Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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31
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Rudaz D, Vandeleur CL, Gholam M, Castelao E, Strippoli MPF, Marquet P, Aubry JM, Merikangas KR, Preisig M. Psychopathological precursors of the onset of mood disorders in offspring of parents with and without mood disorders: results of a 13-year prospective cohort high-risk study. J Child Psychol Psychiatry 2021; 62:404-413. [PMID: 32841378 DOI: 10.1111/jcpp.13307] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 11/18/2019] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND There is still limited evidence from prospective high-risk research on the evolution of specific disorders that may emerge early in the development of mood disorders. Moreover, few studies have examined the specificity of mood disorder subtypes among offspring of parents with both major subtypes of mood disorders and controls based on prospective tracking across the transition from childhood to adulthood. Our specific objectives were to (a) identify differences in patterns of psychopathological precursors among youth with (hypo)mania compared to MDD and (b) examine whether these patterns differ by subtypes of parental mood disorders. METHODS Our data stem from a prospective cohort study of 449 directly interviewed offspring (51% female, mean age 10.1 years at study intake) of 88 patients with BPD, 71 with MDD, 30 with substance use disorders and 60 medical controls. The mean duration of follow-up was 13.2 years with evaluations conducted every three years. RESULTS Within the whole cohort of offspring, MDE (Hazard Ratio = 4.44; 95%CI: 2.19-9.02), CD (HR = 3.31;1.55-7.07) and DUD (HR = 2.54; 1.15-5.59) predicted the onset of (hypo)manic episodes, whereas MDD in offspring was predicted by SAD (HR = 1.53; 1.09-2.15), generalized anxiety (HR = 2.56; 1.05-6.24), and panic disorder (HR = 3.13; 1.06-9.23). The early predictors of (hypo)mania in the whole cohort were also significantly associated with the onset of (hypo)mania among the offspring of parents with BPD. CONCLUSIONS The onset of mood disorders is frequently preceded by identifiable depressive episodes and nonmood disorders. These precursors differed by mood subtype in offspring. High-risk offspring with these precursors should be closely monitored to prevent the further development of MDD or conversion to BPD.
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Affiliation(s)
- Dominique Rudaz
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Caroline L Vandeleur
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mehdi Gholam
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie-Pierre F Strippoli
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pierre Marquet
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Institute of Mental Health, Laval University, Québec, QC, Canada
| | - Jean-Michel Aubry
- Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Difrancesco S, Riese H, Merikangas KR, Shou H, Zipunnikov V, Antypa N, van Hemert AM, Schoevers RA, Penninx BWJH, Lamers F. Sociodemographic, Health and Lifestyle, Sampling, and Mental Health Determinants of 24-Hour Motor Activity Patterns: Observational Study. J Med Internet Res 2021; 23:e20700. [PMID: 33595445 PMCID: PMC7929740 DOI: 10.2196/20700] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 05/27/2020] [Revised: 08/05/2020] [Accepted: 12/07/2020] [Indexed: 12/28/2022] Open
Abstract
Background Analyzing actigraphy data using standard circadian parametric models and aggregated nonparametric indices may obscure temporal information that may be a hallmark of the circadian impairment in psychiatric disorders. Functional data analysis (FDA) may overcome such limitations by fully exploiting the richness of actigraphy data and revealing important relationships with mental health outcomes. To our knowledge, no studies have extensively used FDA to study the relationship between sociodemographic, health and lifestyle, sampling, and psychiatric clinical characteristics and daily motor activity patterns assessed with actigraphy in a sample of individuals with and without depression/anxiety. Objective We aimed to study the association between daily motor activity patterns assessed via actigraphy and (1) sociodemographic, health and lifestyle, and sampling factors, and (2) psychiatric clinical characteristics (ie, presence and severity of depression/anxiety disorders). Methods We obtained 14-day continuous actigraphy data from 359 participants from the Netherlands Study of Depression and Anxiety with current (n=93), remitted (n=176), or no (n=90) depression/anxiety diagnosis, based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Associations between patterns of daily motor activity, quantified via functional principal component analysis (fPCA), and sociodemographic, health and lifestyle, sampling, and psychiatric clinical characteristics were assessed using generalized estimating equation regressions. For exploratory purposes, function-on-scalar regression (FoSR) was applied to quantify the time-varying association of sociodemographic, health and lifestyle, sampling, and psychiatric clinical characteristics on daily motor activity. Results Four components of daily activity patterns captured 77.4% of the variability in the data: overall daily activity level (fPCA1, 34.3% variability), early versus late morning activity (fPCA2, 16.5% variability), biphasic versus monophasic activity (fPCA3, 14.8% variability), and early versus late biphasic activity (fPCA4, 11.8% variability). A low overall daily activity level was associated with a number of sociodemographic, health and lifestyle, and psychopathology variables: older age (P<.001), higher education level (P=.005), higher BMI (P=.009), greater number of chronic diseases (P=.02), greater number of cigarettes smoked per day (P=.02), current depressive and/or anxiety disorders (P=.05), and greater severity of depressive symptoms (P<.001). A high overall daily activity level was associated with work/school days (P=.02) and summer (reference: winter; P=.03). Earlier morning activity was associated with older age (P=.02), having a partner (P=.009), work/school days (P<.001), and autumn and spring (reference: winter; P=.02 and P<.001, respectively). Monophasic activity was associated with older age (P=.005). Biphasic activity was associated with work/school days (P<.001) and summer (reference: winter; P<.001). Earlier biphasic activity was associated with older age (P=.005), work/school days (P<.001), and spring and summer (reference: winter; P<.001 and P=.005, respectively). In FoSR analyses, age, work/school days, and season were the main determinants having a time-varying association with daily motor activity (all P<.05). Conclusions Features of daily motor activity extracted with fPCA reflect commonly studied factors such as the intensity of daily activity and preference for morningness/eveningness. The presence and severity of depression/anxiety disorders were found to be associated mainly with a lower overall activity pattern but not with the time of the activity. Age, work/school days, and season were the variables most strongly associated with patterns and time of activity, and thus future epidemiological studies on motor activity in depression/anxiety should take these variables into account.
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Affiliation(s)
- Sonia Difrancesco
- Amsterdam Public Health Research Institute, Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - Harriëtte Riese
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, Universitair Medisch Centrum Groningen, University of Groningen, Groningen, Netherlands
| | - Kathleen R Merikangas
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, United States
| | - Haochang Shou
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD, United States
| | - Niki Antypa
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
| | - Robert A Schoevers
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, Universitair Medisch Centrum Groningen, University of Groningen, Groningen, Netherlands
| | - Brenda W J H Penninx
- Amsterdam Public Health Research Institute, Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - Femke Lamers
- Amsterdam Public Health Research Institute, Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
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33
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Paksarian D, Rudolph KE, Stapp EK, Dunster GP, He J, Mennitt D, Hattar S, Casey JA, James P, Merikangas KR. Association of Outdoor Artificial Light at Night With Mental Disorders and Sleep Patterns Among US Adolescents. JAMA Psychiatry 2020; 77:1266-1275. [PMID: 32639562 PMCID: PMC7344797 DOI: 10.1001/jamapsychiatry.2020.1935] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [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] [Indexed: 01/07/2023]
Abstract
IMPORTANCE Indoor nighttime light exposure influences sleep and circadian rhythms and is known to affect mood-associated brain circuits in animals. However, little is known about the association between levels of nighttime outdoor light and sleep and mental health in the population, especially among adolescents. OBJECTIVE To estimate associations of outdoor artificial light at night (ALAN) with sleep patterns and past-year mental disorder among US adolescents. DESIGN, SETTING, AND PARTICIPANTS This population-based, cross-sectional study of US adolescents used the National Comorbidity Survey-Adolescent Supplement, a nationally representative cross-sectional survey conducted from February 2001 through January 2004. A probability sample of adolescents aged 13 to 18 years was included. Analyses were conducted between February 2019 and April 2020. EXPOSURES Levels of outdoor ALAN, measured by satellite, with means calculated within census block groups. ALAN values were transformed into units of radiance (nW/cm2/sr). MAIN OUTCOMES AND MEASURES Self-reported habitual sleep patterns (weeknight bedtime, weeknight sleep duration, weekend bedtime delay, and weekend oversleep) and past-year mood, anxiety, behavior, and substance use disorders, measured via an in-person structured diagnostic interview. Parent-reported information was included in behavior disorder diagnoses. RESULTS Among 10 123 adolescents (4953 boys [51.3%]; mean [SE] age, 15.2 [0.06] years [weighted]; 6483 for behavior disorder outcomes), ALAN was positively associated with indicators of social disadvantage, such as racial/ethnic minority status (median [IQR] ALAN: white adolescents, 12.96 [30.51] nW/cm2/sr; Hispanic adolescents: 38.54 [47.84] nW/cm2/sr; non-Hispanic black adolescents: 37.39 [51.88] nW/cm2/sr; adolescents of other races/ethnicities: 30.94 [49.93] nW/cm2/sr; P < .001) and lower family income (median [IQR] ALAN by family income-to-poverty ratio ≤1.5: 26.76 [52.48] nW/cm2/sr; >6: 21.46 [34.38] nW/cm2/sr; P = .005). After adjustment for several sociodemographic characteristics, as well as area-level population density and socioeconomic status, this study found that higher ALAN levels were associated with later weeknight bedtime, and those in the lowest quartile of ALAN reported the longest weeknight sleep duration. Those in the highest quartile of ALAN went to bed 29 (95% CI, 15-43) minutes later and reported 11 (95% CI, 19-2) fewer minutes of sleep than those in the lowest quartile. ALAN was also positively associated with prevalence of past-year mood and anxiety disorder: each median absolute deviation increase in ALAN was associated with 1.07 (95% CI, 1.00-1.14) times the odds of mood disorder and 1.10 (95% CI, 1.05-1.16) times the odds of anxiety disorder. Further analyses revealed associations with bipolar disorder (odds ratio [OR], 1.19 [95% CI, 1.05-1.35]), specific phobias (OR, 1.18 [95% CI, 1.11-1.26]), and major depressive disorder or dysthymia (OR, 1.07 [95% CI, 1.00-1.15]). Among adolescent girls, differences in weeknight bedtime by ALAN (third and fourth quartiles vs first quartile) were greater with increasing years since menarche (F3, 8.15; P < .001). CONCLUSIONS AND RELEVANCE In this study, area-level outdoor ALAN was associated with less favorable sleep patterns and mood and anxiety disorder in adolescents. Future studies should elucidate whether interventions to reduce exposure to ALAN may positively affect mental and sleep health.
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Affiliation(s)
- Diana Paksarian
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Kara E. Rudolph
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, New York
| | - Emma K. Stapp
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Gideon P. Dunster
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Jianping He
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Daniel Mennitt
- Mechanical Engineering Practice, Exponent, Denver, Colorado
| | - Samer Hattar
- Section on Light and Circadian Rhythms, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Joan A. Casey
- Mailman School of Public Health, Department of Environmental Health Sciences, Columbia University, New York, New York
| | - Peter James
- Harvard Pilgrim Health Care Institute, Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School, Boston, Maryland,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Maryland
| | - Kathleen R. Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
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34
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Walsh RFL, Sheppard B, Cui L, Brown C, Van Meter A, Merikangas KR. Comorbidity and patterns of familial aggregation in attention-deficit/hyperactivity disorder and bipolar disorder in a family study of affective and anxiety spectrum disorders. J Psychiatr Res 2020; 130:355-361. [PMID: 32882577 DOI: 10.1016/j.jpsychires.2020.08.017] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/03/2020] [Accepted: 08/14/2020] [Indexed: 01/03/2023]
Abstract
The aim of this study is to examine the familial aggregation of Attention-deficit/hyperactivity disorder (ADHD) and its cross-transmission with bipolar disorder (BD) in a community-based family study of mood spectrum disorders. A clinically-enriched community sample of 562 probands recruited from the greater Washington, DC metropolitan area and their 698 directly interviewed relatives were included in analyses. Inclusion criteria were English speaking and consent to contact at least two first-degree relatives. Standard family study methodology was used and DSM-IV classified mental disorders were ascertained through a best-estimate procedure based on direct semi-structured interviews and multiple family history reports. There was specificity of familial aggregation of both bipolar I disorder (BD I) and bipolar II disorder (BD II) (i.e., BD I OR = 6.08 [1.66, 22.3]; BD II OR = 2.98 [1.11, 7.96]) and ADHD (ADHD OR = 2.13 [1.16, 3.95]). However, there was no evidence for cross-transmission of BD and ADHD in first degree relatives (i.e., did not observe increased rates of BD in relatives of those with ADHD and vice versa; all ps > 0.05). The specificity of familial aggregation of ADHD and BD alongside the absence of shared familial risk are consistent with the notion that the comorbidity between ADHD and BD may be attributable to diagnostic artifact, could represent a distinct BD suptype characterized by childhood-onset symptoms, or the possibility that attention problems serve as a precursor or consequence of BD.
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Affiliation(s)
- Rachel F L Walsh
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Intramural Research Program, Building 35A, Room 2E410, MSC 3720, Bethesda, MD, 20892, USA.
| | - Brooke Sheppard
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Intramural Research Program, Building 35A, Room 2E410, MSC 3720, Bethesda, MD, 20892, USA; Department of Epidemiology, Johns Hopkins' Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, MD, 21205, USA
| | - Lihong Cui
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Intramural Research Program, Building 35A, Room 2E410, MSC 3720, Bethesda, MD, 20892, USA
| | - Cortlyn Brown
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Intramural Research Program, Building 35A, Room 2E410, MSC 3720, Bethesda, MD, 20892, USA
| | - Anna Van Meter
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Intramural Research Program, Building 35A, Room 2E410, MSC 3720, Bethesda, MD, 20892, USA; The Feinstein Institutes for Medical Research, The Zucker Hillside Hospital, Division of Psychiatry Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Intramural Research Program, Building 35A, Room 2E410, MSC 3720, Bethesda, MD, 20892, USA.
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35
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Nikolaidis A, Paksarian D, Alexander L, Derosa J, Dunn J, Nielson DM, Droney I, Kang M, Douka I, Bromet E, Milham M, Stringaris A, Merikangas KR. The Coronavirus Health and Impact Survey (CRISIS) reveals reproducible correlates of pandemic-related mood states across the Atlantic. medRxiv 2020:2020.08.24.20181123. [PMID: 32869041 PMCID: PMC7457620 DOI: 10.1101/2020.08.24.20181123] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic and its social and economic consequences have had adverse impacts on physical and mental health worldwide and exposed all segments of the population to protracted uncertainty and daily disruptions. The CoRonavIruS health and Impact Survey (CRISIS) was developed for use as an easy to implement and robust questionnaire covering key domains relevant to mental distress and resilience during the pandemic. In the current work, we demonstrate the feasibility, psychometric structure and construct validity of this survey. We then show that pre-existing mood states, perceived COVID risk, and lifestyle changes are strongly associated with negative mood states during the pandemic in population samples of adults and in parents reporting on their children in the US and UK. Ongoing studies using CRISIS include international studies of COVID-related ill health conducted during different phases of the pandemic and follow-up studies of cohorts characterized before the COVID pandemic.
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Affiliation(s)
- Aki Nikolaidis
- Center for the Developing Brain, The Child Mind Institute, New York, NY
| | - Diana Paksarian
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD
| | - Lindsay Alexander
- Center for the Developing Brain, The Child Mind Institute, New York, NY
| | - Jacob Derosa
- Center for the Developing Brain, The Child Mind Institute, New York, NY
| | - Julia Dunn
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD
| | - Dylan M Nielson
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Irene Droney
- Center for the Developing Brain, The Child Mind Institute, New York, NY
| | - Minji Kang
- Center for the Developing Brain, The Child Mind Institute, New York, NY
| | - Ioanna Douka
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Evelyn Bromet
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University
| | - Michael Milham
- Center for the Developing Brain, The Child Mind Institute, New York, NY
- Nathan Kline Institute for Psychiatric Research
| | - Argyris Stringaris
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD
- Johns Hopkins Bloomberg School of Public Health
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36
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Stapp EK, Williams SC, Kalb LG, Holingue CB, Van Eck K, Ballard ED, Merikangas KR, Gallo JJ. Mood disorders, childhood maltreatment, and medical morbidity in US adults: An observational study. J Psychosom Res 2020; 137:110207. [PMID: 32745641 PMCID: PMC7855245 DOI: 10.1016/j.jpsychores.2020.110207] [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] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 07/13/2020] [Accepted: 07/26/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Mood disorders, child maltreatment, and medical morbidity are associated with enormous public health burden and individual suffering. The effect of mood disorders on medical morbidity, accounting for child maltreatment, has not been studied prospectively in a large, representative sample of community-dwelling US adults. This study tested the effects of mood disorders and child maltreatment on medical morbidity, and variation by subtypes. METHODS Participants were noninstitutionalized US adults in the National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093 wave 1, N = 34,653 wave 2). Mood disorders included lifetime DSM-IV episodes of depression, dysthymia, mania, or hypomania. Child maltreatment was defined as sexual, physical, or emotional abuse, or physical or emotional neglect before age 18. Survey-weighted zero-inflated poisson regression was used to study effects on medical morbidity, a summary score of 11 self-reported medical conditions. Results were adjusted for age, sex, ethnicity/race, income, substance use disorders, smoking, and obesity. RESULTS Mood disorders and child maltreatment additively associated with medical morbidity at study entry and three years later, with similar magnitude as obesity and smoking. Mania/hypomania (incidence rate ratio [IRR] 1.06, 95% CI 1.01-1.10) and child sexual (IRR 1.08, 95% CI 1.04-1.11) and emotional (IRR 1.05, 95% CI 1.01-1.10) abuse were associated with higher medical morbidity longitudinally. CONCLUSIONS Child maltreatment is common, and its long-range negative effect on medical morbidity underscores the importance of trauma-informed care, and consideration of early life exposures. History of mania/hypomania should be considered in medical practice, and physical health must be emphasized in mental health care.
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Affiliation(s)
- Emma K Stapp
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Stacey C Williams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Luther G Kalb
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Kennedy Krieger Institute, Baltimore, MD, USA
| | - Calliope B Holingue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Kennedy Krieger Institute, Baltimore, MD, USA
| | | | - Elizabeth D Ballard
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Joseph J Gallo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Paksarian D, Trabjerg BB, Merikangas KR, Mors O, Børglum AD, Hougaard DM, Nordentoft M, Werge T, Pedersen CB, Mortensen PB, Agerbo E, Horsdal HT. Adolescent residential mobility, genetic liability and risk of schizophrenia, bipolar disorder and major depression. Br J Psychiatry 2020; 217:390-396. [PMID: 32024557 PMCID: PMC8130005 DOI: 10.1192/bjp.2020.8] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Residential mobility during upbringing, and especially adolescence, is associated with multiple negative mental health outcomes. However, whether associations are confounded by unmeasured familial factors, including genetic liability, is unclear. AIMS We used a population-based case-cohort study to assess whether polygenic risk scores (PRSs) for schizophrenia, bipolar disorder and major depression were associated with mobility from ages 10-14 years, and whether PRS and parental history of mental disorder together explained associations between mobility and each disorder. METHOD Information on cases (n = 4207 schizophrenia, n = 1402 bipolar disorder, n = 18 215 major depression) and a random population sample (n = 17 582), born 1981-1997, was linked between Danish civil and psychiatric registries. Genome-wide data were obtained from the Danish Neonatal Screening Biobank and PRSs were calculated based on results of separate, large meta-analyses. RESULTS PRSs for schizophrenia and major depression were weakly associated with moving once (odds ratio 1.07, 95% CI 1.00-1.16; and odds ratio 1.10, 95% CI 1.04-1.17, respectively), but not twice or three or more times. Mobility was positively associated with each disorder, with more moves associated with greater risk. Adjustment for PRS produced slight reductions in the magnitude of associations. Adjustment for PRS and parental history of mental disorder together reduced estimates by 5-11%. In fully adjusted models mobility was associated with all three disorders; hazard ratios ranged from 1.33 (95% CI 1.08-1.62; one move and bipolar disorder) to 3.05 (95% CI 1.92-4.86; three or more moves and bipolar disorder). CONCLUSIONS Associations of mobility with schizophrenia, bipolar disorder and depression do not appear to be attributable to genetic liability as measured here. Potential familial confounding of mobility associations may be predominantly environmental in nature.
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Affiliation(s)
- Diana Paksarian
- National Institute of Mental Health, Bethesda, Maryland, USA
| | - Betina B Trabjerg
- NCRR-National Center for Register-Based Research, Business and Social Sciences, Aarhus University, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark,CIRRAU–Centre for Integrated Register-Based Research, Aarhus University, Denmark
| | | | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Denmark
| | - Anders D. Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark,Department of Biomedicine and Centre for Integrative Sequencing, iSEQ, Aarhus University, Denmark,Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - David M. Hougaard
- Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health – CORE, Mental Health Centre Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Thomas Werge
- Institute of Biological Psychiatry, Mental Health Services Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Carsten B. Pedersen
- NCRR-National Center for Register-Based Research, Business and Social Sciences, Aarhus University, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark,CIRRAU–Centre for Integrated Register-Based Research, Aarhus University, Denmark
| | - Preben B. Mortensen
- NCRR-National Center for Register-Based Research, Business and Social Sciences, Aarhus University, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark,CIRRAU–Centre for Integrated Register-Based Research, Aarhus University, Denmark
| | - Esben Agerbo
- NCRR-National Center for Register-Based Research, Business and Social Sciences, Aarhus University, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark,CIRRAU–Centre for Integrated Register-Based Research, Aarhus University, Denmark
| | - Henriette Thisted Horsdal
- NCRR-National Center for Register-Based Research, Business and Social Sciences, Aarhus University, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
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Restrepo A, Scheininger T, Clucas J, Alexander L, Salum GA, Georgiades K, Paksarian D, Merikangas KR, Milham MP. Problematic internet use in children and adolescents: associations with psychiatric disorders and impairment. BMC Psychiatry 2020; 20:252. [PMID: 32456610 PMCID: PMC7251845 DOI: 10.1186/s12888-020-02640-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 11/04/2019] [Accepted: 04/30/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Problematic internet use (PIU) is an increasingly worrisome issue, as youth population studies are establishing links with internalizing and externalizing problems. There is a need for a better understanding of psychiatric diagnostic profiles associated with this issue, as well as its unique contributions to impairment. Here, we leveraged the ongoing, large-scale Child Mind Institute Healthy Brain Network, a transdiagnostic self-referred, community sample of children and adolescents (ages 5-21), to examine the associations between PIU and psychopathology, general impairment, physical health and sleep disturbances. METHODS A total sample of 564 (190 female) participants between the ages of 7-15 (mean = 10.80, SD = 2.16), along with their parents/guardians, completed diagnostic interviews with clinicians, answered a wide range of self-report (SR) and parent-report (PR) questionnaires, including the Internet Addiction Test (IAT) and underwent physical testing as part of the Healthy Brain Network protocol. RESULTS PIU was positively associated with depressive disorders (SR: aOR = 2.43, CI: 1.22-4.74, p = .01; PR: aOR = 2.56, CI: 1.31-5.05, p = .01), the combined presentation of ADHD (SR: aOR = 1.91, CI: 1.14-3.22, p = .01; PR: n.s.), Autism Spectrum Disorder (SR: n.s.; PR: aOR = 2.24, CI: 1.34-3.73, p < .001), greater levels of impairment (SR: Standardized Beta = 4.63, CI: 3.06-6.20, p < .001; PR: Standardized Beta = 5.05, CI: 3.67-6.42, p < .001) and increased sleep disturbances (SR: Standardized Beta = 3.15, CI: 0.71-5.59, p = .01; PR: Standardized Beta = 3.55, CI: 1.34-5.75, p < .001), even when accounting for demographic covariates and psychiatric comorbidity. CONCLUSIONS The association between PIU and psychopathology, as well as its impact on impairment and sleep disturbances, highlight the urgent need to gain an understanding of mechanisms in order to inform public health recommendations on internet use in U.S. youth.
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Affiliation(s)
- Anita Restrepo
- grid.428122.f0000 0004 7592 9033Healthy Brain Network, Child Mind Institute, New York, NY USA
| | - Tohar Scheininger
- grid.428122.f0000 0004 7592 9033Healthy Brain Network, Child Mind Institute, New York, NY USA
| | - Jon Clucas
- grid.428122.f0000 0004 7592 9033MATTER Lab, Child Mind Institute, New York, NY USA
| | - Lindsay Alexander
- grid.428122.f0000 0004 7592 9033Healthy Brain Network, Child Mind Institute, New York, NY USA
| | - Giovanni A. Salum
- grid.8532.c0000 0001 2200 7498Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Kathy Georgiades
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Diana Paksarian
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD USA
| | - Kathleen R. Merikangas
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD USA
| | - Michael P. Milham
- grid.428122.f0000 0004 7592 9033Healthy Brain Network, Child Mind Institute, New York, NY USA ,grid.428122.f0000 0004 7592 9033Center for the Developing Brain, Child Mind Institute, New York, NY USA ,grid.250263.00000 0001 2189 4777Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, USA ,grid.428122.f0000 0004 7592 9033Child Mind Institute, New York, NY USA
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Stapp EK, Mendelson T, Merikangas KR, Wilcox HC. Parental bipolar disorder, family environment, and offspring psychiatric disorders: A systematic review. J Affect Disord 2020; 268:69-81. [PMID: 32158009 PMCID: PMC7175999 DOI: 10.1016/j.jad.2020.03.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 10/07/2019] [Revised: 01/27/2020] [Accepted: 03/02/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Our objective was to systematically review non-experimental studies of parental bipolar disorder (BD), current family environment, and offspring psychiatric disorders to identify characteristics of family environment associated with parental BD and risk for offspring psychiatric disorders. METHODS CINAHL, Embase, PsycINFO, and PubMed were searched using MeSH terms to identify studies on offspring of BD parents published through September 2017. We followed PRISMA guidelines and used the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). We calculated prevalence ratios and 95% confidence intervals to compare offspring psychiatric disorders within and across studies. RESULTS Of 10,454 unique documents retrieved, we included 13 studies. The most consistent finding was lower parent-reported cohesion in families with a BD parent versus no parental psychiatric disorders. Family environment did not differ between BD parents and parents with other disorders. Offspring of BD parents had higher prevalence of psychiatric disorders than offspring of parents without psychiatric disorders but did not differ from offspring of parents with other disorders. Families with a BD child had higher conflict than families without a BD child. LIMITATIONS Comparisons between studies were qualitative. A single reviewer conducted screening, data extraction, and bias assessment. CONCLUSIONS Family environment in families with a BD parent is heterogeneous. The pattern of findings across studies also suggests that family problems may be associated with parental psychiatric illness generally rather than parental BD in particular. Few studies included offspring-reported measures. Given the association of family conflict with offspring mood disorders, further study is merited on children's perceptions of the family environment in the BD high-risk context.
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Affiliation(s)
- Emma K Stapp
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA.
| | - Tamar Mendelson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Holly C Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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40
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Ballard ED, Farmer CA, Shovestul B, Voort JV, Machado-Vieira R, Park L, Merikangas KR, Zarate CA. Symptom trajectories in the months before and after a suicide attempt in individuals with bipolar disorder: A STEP-BD study. Bipolar Disord 2020; 22:245-254. [PMID: 31737973 PMCID: PMC7289321 DOI: 10.1111/bdi.12873] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The suicide crisis is a relatively short-lived psychiatric emergency, with transient symptoms that ebb and flow around the suicide attempt. Understanding the dynamic processes of symptoms before and after suicide attempt may aid future prevention efforts. METHODS Data were drawn from the NIMH STEP-BD study, which followed 4,360 patients with bipolar disorder; a subset attempted suicide during the trial (245/4100 or 5.97% of the sample eligible for analysis). This analysis focused on change in suicidal ideation (SI) in the 120 days before and 120 days after suicide attempt; similar analyses were conducted for other depressive symptoms. Generalized linear mixed models with a two-piece linear function of time corresponding to pre- and post-suicide attempt trends were used. RESULTS SI ratings from 216 individuals were analyzed (n = 1,231 total; n = 395 pre-attempt, n = 126 circa-attempt, n = 710 post-attempt) and compared to data from a matched sample of 648 non-attempters. SI worsened in the 120 days pre-attempt but improved afterwards, reaching non-attempter levels by 90 days post-attempt. A similar pattern was found for other depressive symptoms, including depressed mood, loss of interest, guilt, and self-esteem. Pre/post differences in tension/activating symptoms of depression-anxiety, agitation, and irritability-were less pronounced and more time-limited. CONCLUSIONS The suicide crisis is dynamic, and the days before and after suicide attempt may be particularly critical. The findings extend previous research on proximal symptoms of suicide and underscore that some SI and affective/cognitive symptoms of depression can remain elevated up to 90 days post-attempt in individuals with bipolar disorder.
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Affiliation(s)
- Elizabeth D. Ballard
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Cristan A. Farmer
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Bridget Shovestul
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | | | - Rodrigo Machado-Vieira
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Science Center, Houston, TX, USA
| | - Lawrence Park
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Kathleen R. Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Carlos A. Zarate
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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Atkinson JA, Song YJC, Merikangas KR, Skinner A, Prodan A, Iorfino F, Freebairn L, Rose D, Ho N, Crouse J, Zipunnikov V, Hickie IB. The Science of Complex Systems Is Needed to Ameliorate the Impacts of COVID-19 on Mental Health. Front Psychiatry 2020; 11:606035. [PMID: 33324266 PMCID: PMC7724045 DOI: 10.3389/fpsyt.2020.606035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/30/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Jo-An Atkinson
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.,Computer Simulation and Advanced Research Technologies (CSART), Sydney, NSW, Australia
| | - Yun Ju Christine Song
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Kathleen R Merikangas
- Intramural Research Program, National Institute of Mental Health, Bethesda, MD, United States
| | - Adam Skinner
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Ante Prodan
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.,Computer Simulation and Advanced Research Technologies (CSART), Sydney, NSW, Australia.,School of Computer, Data and Mathematical Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Frank Iorfino
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Louise Freebairn
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.,The Australian Prevention Partnership Centre, Sydney, NSW, Australia
| | - Danya Rose
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Nicholas Ho
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Jacob Crouse
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Vadim Zipunnikov
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Ian B Hickie
- Youth Mental Health and Technology, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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Chung W, Jiang SF, Paksarian D, Nikolaidis A, Castellanos FX, Merikangas KR, Milham MP. Trends in the Prevalence and Incidence of Attention-Deficit/Hyperactivity Disorder Among Adults and Children of Different Racial and Ethnic Groups. JAMA Netw Open 2019; 2:e1914344. [PMID: 31675080 PMCID: PMC6826640 DOI: 10.1001/jamanetworkopen.2019.14344] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE An increasing prevalence of adult attention-deficit/hyperactivity disorder (ADHD) diagnosis and treatment has been reported in clinical settings and administrative data in the United States. However, there are limited data on recent trends of adult ADHD diagnosis among racial/ethnic subgroups. OBJECTIVE To examine trends, including associated demographic characteristics, psychiatric diagnoses, and negative outcomes, in the prevalence and incidence of adult ADHD diagnosis among 7 racial/ethnic groups during a 10-year period. DESIGN, SETTING, AND PARTICIPANTS This cohort study investigated trends in the diagnosis of ADHD in adults who identified as African American or black, Native American, Pacific Islander, Latino or Hispanic, non-Hispanic white, Asian American, or other using the Kaiser Permanente Northern California health plan medical records. A total of 5 282 877 adult patients and 867 453 children aged 5 to 11 years who received care at Kaiser Permanente Northern California from January 1, 2007, to December 31, 2016, were included. Data analysis was performed from January 2017 through September 2019. EXPOSURES Period of ADHD diagnosis. MAIN OUTCOMES AND MEASURES Prevalence and incidence of licensed mental health clinician-diagnosed ADHD in adults and prevalence of licensed mental health clinician-diagnosed ADHD in children aged 5 to 11 years. RESULTS Of 5 282 877 adult patients (1 155 790 [21.9%] aged 25-34 years; 2 667 562 [50.5%] women; 2 204 493 [41.7%] white individuals), 59 371 (1.12%) received diagnoses of ADHD. Prevalence increased from 0.43% in 2007 to 0.96% in 2016. Among 867 453 children aged 5 to 11 years (424 449 [48.9%] girls; 260 236 [30.0%] white individuals), prevalence increased from 2.96% in 2007 to 3.74% in 2016. During the study period, annual adult ADHD prevalence increased for every race/ethnicity, but white individuals consistently had the highest prevalence rates (white individuals: 0.67%-1.42%; black individuals: 0.22%-0.69%; Native American individuals: 0.56%-1.14%; Pacific Islander individuals: 0.11%-0.39%; Hispanic or Latino individuals: 0.25%-0.65%; Asian American individuals: 0.11%-0.35%; individuals from other races/ethnicities: 0.29%-0.71%). Incidence of ADHD diagnosis per 10 000 person-years increased from 9.43 in 2007 to 13.49 in 2016. Younger age (eg, >65 years vs 18-24 years: odds ratio [OR], 0.094; 95% CI, 0.088-0.101; P < .001), male sex (women: OR, 0.943; 95% CI, 0.928-0.959; P < .001), white race (eg, Asian patients vs white patients: OR, 0.248; 95% CI, 0.240-0.257; P < .001), being divorced (OR, 1.131; 95% CI, 1.093-1.171; P < .001), being employed (eg, retired vs employed persons: OR, 0.278; 95% CI, 0.267-0.290; P < .001), and having a higher median education level (OR, 2.156; 95% CI, 2.062-2.256; P < .001) were positively associated with odds of ADHD diagnosis. Having an eating disorder (OR, 5.192; 95% CI, 4.926-5.473; P < .001), depressive disorder (OR, 4.118; 95% CI, 4.030-4.207; P < .001), bipolar disorder (OR, 4.722; 95% CI, 4.556-4.894; P < .001), or anxiety disorder (OR, 2.438; 95% CI, 2.385-2.491; P < .001) was associated with higher odds of receiving an ADHD diagnosis. Adults with ADHD had significantly higher odds of frequent health care utilization (OR, 1.303; 95% CI, 1.272-1.334; P < .001) and sexually transmitted infections (OR, 1.289; 95% CI 1.251-1.329; P < .001) compared with adults with no ADHD diagnosis. CONCLUSIONS AND RELEVANCE This study confirmed the reported increases in rates of ADHD diagnosis among adults, showing substantially lower rates of detection among minority racial/ethnic subgroups in the United States. Higher odds of negative outcomes reflect the economic and personal consequences that substantiate the need to improve assessment and treatment of ADHD in adults.
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Affiliation(s)
- Winston Chung
- Department of Psychiatry, Kaiser Permanente Northern California, San Francisco
| | - Sheng-Fang Jiang
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Diana Paksarian
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Aki Nikolaidis
- Center for the Developing Brain, Child Mind Institute, New York, New York
| | - F. Xavier Castellanos
- Department of Child and Adolescent Psychiatry, Hassenfeld Children’s Hospital at NYU Langone, New York, New York
- Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York
| | - Kathleen R. Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Michael P. Milham
- Center for the Developing Brain, Child Mind Institute, New York, New York
- Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York
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Pisanu C, Lundin E, Preisig M, Gholam-Rezaee M, Castelao E, Pistis G, Merikangas KR, Glaus J, Squassina A, Del Zompo M, Schiöth HB, Mwinyi J. Major depression subtypes are differentially associated with migraine subtype, prevalence and severity. Cephalalgia 2019; 40:347-356. [DOI: 10.1177/0333102419884935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective Migraine and major depressive disorder show a high rate of comorbidity, but little is known about the associations between the subtypes of major depressive disorder and migraine. In this cross-sectional study we aimed at investigating a) the lifetime associations between the atypical, melancholic, combined and unspecified subtype of major depressive disorder and migraine with and without aura and b) the associations between major depressive disorder and its subtypes and the severity of migraine. Methods A total of 446 subjects with migraine (migraine without aura: n = 294; migraine with aura: n = 152) and 2511 controls from the population-based CoLaus/PsyCoLaus study, Switzerland, were included. Associations between major depressive disorder subtypes and migraine characteristics were tested using binary logistic or linear regression. Results Melancholic, combined and unspecified major depressive disorder were associated with increased frequency of migraine with aura, whereas only melancholic major depressive disorder was associated with increased frequency of migraine without aura. Lifetime and unspecified major depressive disorder were associated with severe migraine intensity among subjects with migraine with aura but not migraine without aura, while combined major depressive disorder was associated with higher migraine frequency independently from migraine subtype. Conclusion This study suggests that melancholic but not atypical major depressive disorder is associated with migraine and migraine subtypes. Future studies exploring pathophysiological mechanisms shared between melancholic depression and migraine are warranted.
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Affiliation(s)
- Claudia Pisanu
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Emma Lundin
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | | | - Enrique Castelao
- Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Giorgio Pistis
- Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Jennifer Glaus
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Alessio Squassina
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Maria Del Zompo
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Helgi B Schiöth
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden
- Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Jessica Mwinyi
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden
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Difrancesco S, Lamers F, Riese H, Merikangas KR, Beekman ATF, van Hemert AM, Schoevers RA, Penninx BWJH. Sleep, circadian rhythm, and physical activity patterns in depressive and anxiety disorders: A 2-week ambulatory assessment study. Depress Anxiety 2019; 36:975-986. [PMID: 31348850 PMCID: PMC6790673 DOI: 10.1002/da.22949] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [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: 07/04/2018] [Revised: 05/15/2019] [Accepted: 07/07/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Actigraphy may provide a more valid assessment of sleep, circadian rhythm (CR), and physical activity (PA) than self-reported questionnaires, but has not been used widely to study the association with depression/anxiety and their clinical characteristics. METHODS Fourteen-day actigraphy data of 359 participants with current (n = 93), remitted (n = 176), or no (n = 90) composite international diagnostic interview depression/anxiety diagnoses were obtained from the Netherlands Study of Depression and Anxiety. Objective estimates included sleep duration (SD), sleep efficiency, relative amplitude (RA) between day-time and night-time activity, mid sleep on free days (MSF), gross motor activity (GMA), and moderate-to-vigorous PA (MVPA). Self-reported measures included insomnia rating scale, SD, MSF, metabolic equivalent total, and MVPA. RESULTS Compared to controls, individuals with current depression/anxiety had a significantly different objective, but not self-reported, PA and CR: lower GMA (23.83 vs. 27.4 milli-gravity/day, p = .022), lower MVPA (35.32 vs. 47.64 min/day, p = .023), lower RA (0.82 vs. 0.83, p = .033). In contrast, self-reported, but not objective, sleep differed between people with current depression/anxiety compared to those without current disorders; people with current depression/anxiety reported both shorter and longer SD and more insomnia. More depressive/anxiety symptoms and number of depressive/anxiety diagnoses were associated with larger disturbances of the actigraphy measures. CONCLUSION Actigraphy provides ecologically valid information on sleep, CR, and PA that enhances data from self-reported questionnaires. As those with more severe or comorbid forms showed the lowest PA and most CR disruptions, the potential for adjunctive behavioral and chronotherapy interventions should be explored, as well as the potential of actigraphy to monitor treatment response to such interventions.
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Affiliation(s)
- Sonia Difrancesco
- Amsterdam UMC, Vrije Universiteit, PsychiatryAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Femke Lamers
- Amsterdam UMC, Vrije Universiteit, PsychiatryAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Harriëtte Riese
- University of Groningen, University Medical Center Groningen, Department of PsychiatryInterdisciplinary Center for Psychopathology and Emotion RegulationGroningenThe Netherlands
| | - Kathleen R. Merikangas
- Genetic Epidemiology Branch, Intramural Research ProgramNational Institute of Mental HealthBethesdaMaryland
| | - Aartjan T. F. Beekman
- Amsterdam UMC, Vrije Universiteit, PsychiatryAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | | | - Robert A. Schoevers
- University of Groningen, University Medical Center Groningen, Department of PsychiatryInterdisciplinary Center for Psychopathology and Emotion RegulationGroningenThe Netherlands
| | - Brenda W. J. H. Penninx
- Amsterdam UMC, Vrije Universiteit, PsychiatryAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
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45
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Rudolph KE, Shev A, Paksarian D, Merikangas KR, Mennitt DJ, James P, Casey JA. Environmental noise and sleep and mental health outcomes in a nationally representative sample of urban US adolescents. Environ Epidemiol 2019; 3:e056. [PMID: 31538137 PMCID: PMC6693982 DOI: 10.1097/ee9.0000000000000056] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 02/19/2019] [Accepted: 05/28/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Environmental noise has been linked to negative health outcomes, like poor sleep, poor mental health, and cardiovascular disease, and likely accounts for more than 1 million disability-adjusted life years annually in Western Europe. Adolescence may be a particularly sensitive period for noise exposure due to an increased need for sleep, failure to meet sleep guidelines, and increased risk for first onset of some mental health disorders. However, the potential health effects of living in high-noise environments have not been studied in US adolescents, rarely in European adolescents, and mental health outcomes studied have not corresponded to diagnoses from the Diagnostic and Statistical Manual of Mental Disorders (DSM). METHODS Using a US-based nationally representative survey of urban adolescents (N = 4,508), we estimated associations of day-night average sound levels exceeding the US Environmental Protection Agency's 55 decibel limit with sleep outcomes and lifetime mental health DSM diagnoses. We implemented doubly robust targeted minimum loss-based estimation coupled with propensity score matching to account for numerous potential adolescent, household, and environmental confounders. RESULTS Living in a high- versus low-noise Census block group was associated with later bedtimes on weeknights (0.48 hours, 95% confidence interval [CI] = -0.15, 1.12) and weekend nights (0.65 hours, 95% CI = 0.37, 0.93), but not with total hours slept. Associations between living in a high- versus low-noise Census block group and mental disorders were mixed, with wide CIs, and not robust to sensitivity analyses. CONCLUSIONS We find evidence for an association between residence in a high-noise area and later bedtimes among urban adolescents but no consistent evidence of such an association with mental health disorders.
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Affiliation(s)
- Kara E. Rudolph
- Department of Emergency Medicine, School of Medicine, University of California, Davis, Sacramento, California
| | - Aaron Shev
- Department of Emergency Medicine, School of Medicine, University of California, Davis, Sacramento, California
| | - Diana Paksarian
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Kathleen R. Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Daniel J. Mennitt
- Department of Electrical and Computer Engineering, Colorado State University, Fort Collins, Colorado
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Joan A. Casey
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California
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46
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Angst J, Rössler W, Ajdacic-Gross V, Angst F, Wittchen HU, Lieb R, Beesdo-Baum K, Asselmann E, Merikangas KR, Cui L, Andrade LH, Viana MC, Lamers F, Penninx BW, de Azevedo Cardoso T, Jansen K, Dias de Mattos Souza L, Azevedo da Silva R, Kapczinski F, Grobler C, Gholam-Rezaee M, Preisig M, Vandeleur CL. Differences between unipolar mania and bipolar-I disorder: Evidence from nine epidemiological studies. Bipolar Disord 2019; 21:437-448. [PMID: 30475430 DOI: 10.1111/bdi.12732] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Although clinical evidence suggests important differences between unipolar mania and bipolar-I disorder (BP-I), epidemiological data are limited. Combining data from nine population-based studies, we compared subjects with mania (M) or mania with mild depression (Md) to those with BP-I with both manic and depressive episodes with respect to demographic and clinical characteristics in order to highlight differences. METHODS Participants were compared for gender, age, age at onset of mania, psychiatric comorbidity, temperament, and family history of mental disorders. Generalized linear mixed models with adjustment for sex and age as well as for each study source were applied. Analyses were performed for the pooled adult and adolescent samples, separately. RESULTS Within the included cohorts, 109 adults and 195 adolescents were diagnosed with M/Md and 323 adults and 182 adolescents with BP-I. In both adult and adolescent samples, there was a male preponderance in M/Md, whereas lifetime generalized anxiety and/panic disorders and suicide attempts were less common in M/Md than in BP-I. Furthermore, adults with mania revealed bulimia/binge eating and drug use disorders less frequently than those with BP-I. CONCLUSIONS The significant differences found in gender and comorbidity between mania and BP-I suggest that unipolar mania, despite its low prevalence, should be established as a separate diagnosis both for clinical and research purposes. In clinical settings, the rarer occurrence of suicide attempts, anxiety, and drug use disorders among individuals with unipolar mania may facilitate successful treatment of the disorder and lead to a more favorable course than that of BP-I disorder.
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Affiliation(s)
- Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Felix Angst
- Rehabilitation Clinic, Bad Zurzach, Switzerland
| | - Hans Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Psychiatric University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Rosalind Lieb
- Max Planck Institute of Psychiatry, Munich, Germany.,Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Eva Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Laura H Andrade
- Section of Psychiatric Epidemiology (LIM 23), Department and Institute of Psychiatry, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Maria C Viana
- Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil
| | - Femke Lamers
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - Brenda Wjh Penninx
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | | | - Karen Jansen
- Health and Behavior Graduate Program, Catholic University of Pelotas, Pelotas, Brazil
| | | | | | - Flavio Kapczinski
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Christoffel Grobler
- Elizabeth Donkin Hospital, Port Elizabeth, South Africa.,Nelson Mandela University, Port Elizabeth, South Africa
| | - Mehdi Gholam-Rezaee
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
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47
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Stapp EK, Musci RJ, Fullerton JM, Glowinski AL, McInnis M, Mitchell PB, Hulvershorn LA, Ghaziuddin N, Roberts GM, Merikangas KR, Nurnberger JI, Wilcox HC. Patterns and predictors of family environment among adolescents at high and low risk for familial bipolar disorder. J Psychiatr Res 2019; 114:153-160. [PMID: 31078786 PMCID: PMC6546513 DOI: 10.1016/j.jpsychires.2019.05.003] [Citation(s) in RCA: 9] [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: 01/31/2019] [Revised: 04/10/2019] [Accepted: 05/02/2019] [Indexed: 01/31/2023]
Abstract
Children's perceptions are important to understanding family environment in the bipolar disorder (BD) high-risk context. Our objectives were to empirically derive patterns of offspring-perceived family environment, and to test the association of family environment with maternal or paternal BD accounting for offspring BD and demographic characteristics. Participants aged 12-21 years (266 offspring of a parent with BD, 175 offspring of a parent with no psychiatric history) were recruited in the US and Australia. We modeled family environment using latent profile analysis based on offspring reports on the Conflict Behavior Questionnaire, Family Adaptability and Cohesion Evaluation Scales, and Home Environment Interview for Children. Parent diagnoses were based on the Diagnostic Interview for Genetic Studies and offspring diagnoses were based on the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. Latent class regression was used to test associations of diagnosis and family environment. Two-thirds of all offspring perceived well-functioning family environment, characterized by nurturance, flexibility, and low conflict. Two 'conflict classes' perceived family environments low in flexibility and cohesion, with substantial separation based on high conflict with the father (High Paternal Conflict), or very high conflict and rigidity and low warmth with the mother (High Maternal Conflict). Maternal BD was associated with offspring perceiving High Maternal Conflict (OR 2.8, p = 0.025). Clinical care and psychosocial supports for mothers with BD should address family functioning, with attention to offspring perceptions of their wellbeing. More research is needed on the effect of paternal BD on offspring and family dynamics.
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Affiliation(s)
- Emma K. Stapp
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,National Institute of Mental Health, Bethesda, MD, USA
| | | | - Janice M. Fullerton
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia & School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Anne L. Glowinski
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Melvin McInnis
- Department of Psychiatry and Depression Center, University of Michigan, Ann Arbor, MI
| | - Philip B. Mitchell
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia and Black Dog Institute, Sydney, NSW, Australia
| | - Leslie A. Hulvershorn
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Neera Ghaziuddin
- Department of Psychiatry and Depression Center, University of Michigan, Ann Arbor, MI
| | - Gloria M.P. Roberts
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia and Black Dog Institute, Sydney, NSW, Australia
| | | | - John I. Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA,Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Holly C. Wilcox
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Johns Hopkins School of Medicine, Baltimore, MD, USA
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48
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Kolla BP, He JP, Mansukhani MP, Kotagal S, Frye MA, Merikangas KR. Prevalence and Correlates of Hypersomnolence Symptoms in US Teens. J Am Acad Child Adolesc Psychiatry 2019; 58:712-720. [PMID: 30768408 PMCID: PMC6491259 DOI: 10.1016/j.jaac.2018.09.435] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 05/27/2018] [Revised: 09/24/2018] [Accepted: 10/24/2018] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Recent attention to pervasive sleep deficits in US adolescents has focused on sleep patterns and insomnia, but there are limited data on the prevalence and correlates of hypersomnolence symptoms. METHOD The sample included 6,483 adolescents 13 to 18 years of age who were interviewed directly and had parent reports in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally representative sample of US youth. Information on sleep patterns/symptoms that were collected in the interview was used to determine the population prevalence of DSM-5 criterion A-defined hypersomnolence and component symptoms. Logistic regression analyses were used to examine associations between sleepiness and sub-symptoms of hypersomnolence with weekday/weekend bedtime, sleep duration, mental disorders, and psychotropic medication use. RESULTS Of the sample, 41.5% reported feeling sleepy during the daytime and 11.7% met criteria for hypersomnolence. The prevalence of hypersomnolence varied depending on age (p < .001) and was more common in adolescent girls (odds ratio [OR] 1.40, 95% CI 1.09-1.78). Excessive sleepiness and hypersomnolence symptoms were associated with shorter sleep duration and delayed bedtimes on weekdays and weekends Hypersomnolence was significantly associated with insomnia (OR 2.45, 95% CI 1.87-3.21) and mental disorders (OR 1.99, 95% CI 1.42-2.77). After accounting for insomnia, hypersomnolence was no longer associated with use of psychotropic medication (OR 1.61, 95% CI 0.97-2.66). CONCLUSION Of adolescents with adequate sleep duration, 11.7% still reported symptoms of hypersomnolence. The strong association between hypersomnolence and insomnia suggests that sleep disorders in adolescents can fluctuate between over- and under-sleeping. Potential mechanisms underpinning the strong associations between sleep disturbances and mental disorders should be further pursued and could provide insight into prevention efforts.
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49
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Glaus J, Cui L, Hommer R, Merikangas KR. Association between mood disorders and BMI/overweight using a family study approach. J Affect Disord 2019; 248:131-138. [PMID: 30731280 DOI: 10.1016/j.jad.2019.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 10/10/2018] [Revised: 12/19/2018] [Accepted: 01/12/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND We previously demonstrated the specificity of familial transmission of the atypical subtype of depression, primarily characterized by overeating and oversleeping. However, the specific components of this subtype that are familial have not been established. The aim of this paper is to examine whether the familial specificity of atypical depression can be attributed to the association between Body Mass Index (BMI) and overweight/obesity with mood disorders. METHODS The sample included 293 probands recruited from the community and their 544 adult first-degree relatives. Diagnostic assignment was based on a direct semi-structured interview. Mixed effect models were employed to test the familial aggregation and the familial cross-aggregation of mood disorders and BMI/overweight. RESULTS There were significant within-individual associations between overweight and the atypical subtype of depression (p-value = 0.003). There was also an association for BMI/overweight between probands and relatives (β = 0.23, p-value < 0.001; odds ratio [OR] = 1.57, 95% confidence interval [CI] = 1.02-2.43, respectively). Atypical depression in probands was significantly associated with BMI and overweight in relatives (β = 0.001, p-value = 0.040; OR = 2.79, 95%CI = 1.20-6.49, respectively). LIMITATIONS The cross-sectional design impedes our ability to evaluate the direction of these associations. Other potential risk factors, such as diabetes, physical activity and unhealthy diet were not considered. CONCLUSIONS These findings imply that overweight may be either a precursor or consequence of atypical depression rather than a manifestation of a common diathesis underlying depression in families. Clinicians should pay particular attention to this subtype that could be at increased risk for the development of cardiovascular risk factors and diseases.
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Affiliation(s)
- Jennifer Glaus
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA.
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA
| | - Rebecca Hommer
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA
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50
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Rudolph KE, Goin DE, Paksarian D, Crowder R, Merikangas KR, Stuart EA. Causal Mediation Analysis With Observational Data: Considerations and Illustration Examining Mechanisms Linking Neighborhood Poverty to Adolescent Substance Use. Am J Epidemiol 2019; 188:598-608. [PMID: 30561500 PMCID: PMC6395164 DOI: 10.1093/aje/kwy248] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 02/14/2018] [Revised: 10/19/2018] [Accepted: 10/26/2018] [Indexed: 12/27/2022] Open
Abstract
Understanding the mediation mechanisms by which an exposure or intervention affects an outcome can provide a look into what has been called a "black box" of many epidemiologic associations, thereby providing further evidence of a relationship and possible points of intervention. Rapid methodologic developments in mediation analyses mean that there are a growing number of approaches for researchers to consider, each with its own set of assumptions, advantages, and disadvantages. This has understandably resulted in some confusion among applied researchers. Here, we provide a brief overview of the mediation methods available and discuss points for consideration when choosing a method. We provide an in-depth explication of 2 of the many potential estimators for illustrative purposes: the Baron and Kenny mediation approach, because it is the most commonly used, and a recently developed approach for estimating stochastic direct and indirect effects, because it relies on far fewer assumptions. We illustrate the decision process and analytical procedure by estimating potential school- and peer-based mechanisms linking neighborhood poverty to adolescent substance use in the National Comorbidity Survey Adolescent Supplement.
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Affiliation(s)
- Kara E Rudolph
- Department of Emergency Medicine, University of California, Davis, Sacramento, California
- Division of Epidemiology, University of California, Berkeley, Berkeley, California
| | - Dana E Goin
- Division of Epidemiology, University of California, Berkeley, Berkeley, California
| | - Diana Paksarian
- Division of Genetic Epidemiology, National Institute of Mental Health, Bethesda, Maryland
| | - Rebecca Crowder
- Division of Epidemiology, University of California, Berkeley, Berkeley, California
| | - Kathleen R Merikangas
- Division of Genetic Epidemiology, National Institute of Mental Health, Bethesda, Maryland
| | - Elizabeth A Stuart
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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