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Niemela L, Lamoury G, Carroll S, Morgia M, Yeung A, Oh B. Exploring gender differences in the relationship between gut microbiome and depression - a scoping review. Front Psychiatry 2024; 15:1361145. [PMID: 38439790 PMCID: PMC10910028 DOI: 10.3389/fpsyt.2024.1361145] [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: 12/25/2023] [Accepted: 02/02/2024] [Indexed: 03/06/2024] Open
Abstract
Background Major depressive disorder (MDD) exhibits gender disparities, and emerging evidence suggests the involvement of the gut microbiome, necessitating exploration of sex-specific differences. Methods A review was conducted, encompassing a thorough examination of relevant studies available in Medline via Ovid, Embase via OvidSP, CINAHL, and PsycINFO databases from their inception to June 2023. The search strategy employed specific keywords and Medical Subject Headings (MeSH) terms tailored to major depressive disorder in women, encompassing unipolar depression, depressive symptoms, and dysbiosis. Results Five studies were included. Among the four studies, alterations in alpha (n=1) and beta diversity (n=3) in the gut microbiome of individuals with MDD were revealed compared to controls. Gender-specific differences were observed in four studies, demonstrating the abundance of specific bacterial taxa and highlighting potential sex-specific implications in MDD pathophysiology. Correlation analyses (n=4) indicated associations between certain bacterial taxa and the severity of depressive symptoms, with varying patterns between males and females. Studies (n=3) also highlighted promising findings regarding the potential utility of microbial markers in diagnosing MDD, emphasizing the crucial role of sex stratification in understanding the disease pathophysiology. Conclusions The findings underscore the importance of recognizing gender-specific differences in the composition of the gut microbiome and its relationship with MDD. Further comprehensive robust studies are required to unravel the intricate mechanisms underlying these disparities.
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Affiliation(s)
- Leila Niemela
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Gillian Lamoury
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Susan Carroll
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Marita Morgia
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Albert Yeung
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Byeongsang Oh
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia
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2
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Nyer MB, Hopkins LB, Nagaswami M, Norton R, Streeter CC, Hoeppner BB, Sorensen CEC, Uebelacker L, Koontz J, Foster S, Dording C, Giollabhui NM, Yeung A, Fisher LB, Cusin C, Jain FA, Pedrelli P, Ding GA, Mason AE, Cassano P, Mehta DH, Sauder C, Raison CL, Miller KK, Fava M, Mischoulon D. A Randomized Controlled Trial of Community-Delivered Heated Hatha Yoga for Moderate-to-Severe Depression. J Clin Psychiatry 2023; 84:22m14621. [PMID: 37883245 DOI: 10.4088/jcp.22m14621] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Objective: To evaluate feasibility, acceptability, and preliminary efficacy of heated yoga to treat moderate-to-severe depression. Design: An 8-week randomized controlled trial (RCT) of heated yoga versus waitlist control was conducted from March 2017 to August 2019. Methods: Participants in the yoga condition were asked to attend heated yoga classes at 2 community heated yoga studios at least twice weekly. We assessed acceptability and feasibility using exit interview and attendance data, respectively. The primary intervention efficacy outcome variable was change in the Inventory of Depressive Symptomatology-Clinician Rated (IDS-CR) score from baseline to post-intervention (week 8). Results: We randomized 80 participants and included 65 (mean [± SD] age 32.7 [± 11.7] years; 81.5% female) in the analyses (yoga n = 33, waitlist n = 32). The mean IDS-CR score at baseline was 35.6 (± 7.9) for the full sample, 36.9 (± 8.8) for yoga participants, and 34.4 (± 6.7) for waitlist participants. Participants attended an average of 10.3 (± 7.1) total classes over the 8-week intervention period. Yoga participants had a significantly greater pre- to post-intervention reduction in IDS-CR scores than waitlist participants (Cohen d = 1.04, P < .001). More yoga participants (59.3%; n = 16) than waitlist participants (6.3%; n = 2) evidenced larger treatment responses (IDS-CR ≥ 50% decrease in symptoms). Participants rated the heated yoga and its aftereffects positively in exit interviews. Conclusions: Approximately 1 heated yoga session per week (mean of 10.3 classes over 8 weeks) was associated with significantly greater reduction in depression symptoms than a waitlist control. Participants rated heated yoga positively. Taken together, results suggest feasibility, acceptability, and preliminary efficacy for patients with depression and warrant further research using active control conditions. Trial Registration: ClinicalTrials.gov identifier: NCT02607514.
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Affiliation(s)
- Maren B Nyer
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Corresponding Author: Maren Nyer, PhD, Depression Clinical & Research Program, Massachusetts General Hospital, One Bowdoin Square, 6th Floor, Boston, MA 02139
| | | | - Megha Nagaswami
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Richard Norton
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Chris C Streeter
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Department of Psychiatry and Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Bettina B Hoeppner
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Chloe E C Sorensen
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Lisa Uebelacker
- Alpert Medical School, Brown University, Providence, Rhode Island
- Butler Hospital, Providence, Rhode Island
| | - Jill Koontz
- Blueprint Wellness, LLC, Wakefield, Massachusetts
| | - Simmie Foster
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Christina Dording
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Naoise Mac Giollabhui
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Albert Yeung
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Lauren B Fisher
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Cristina Cusin
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Felipe A Jain
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Paola Pedrelli
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Grace A Ding
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Ashley E Mason
- Osher Center for Integrative Health, University of California, San Francisco (UCSF), San Francisco, California
- Department of Psychiatry, University of California, San Francisco (UCSF), San Francisco, California
| | - Paolo Cassano
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Darshan H Mehta
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Christina Sauder
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Human Development and Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Charles L Raison
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Human Development and Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Karen K Miller
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Alpert Medical School, Brown University, Providence, Rhode Island
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - David Mischoulon
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Trayner K, Yeung A, Sumnall HR, Anderson M, Glancy ME, Atkinson A, Smith M, McAuley A. National increase in the community supply of take-home naloxone associated with a mass media campaign in Scotland: a segmented time series analysis. Int J Drug Policy 2023:104106. [PMID: 37563038 DOI: 10.1016/j.drugpo.2023.104106] [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: 02/23/2023] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Take-home naloxone (THN) programmes have been associated with reductions in opioid-related mortality. In response to high rates of drug-related deaths in Scotland, the Scottish Government commissioned the 'How to save a life' (HTSAL) mass media campaign to: (1) increase awareness of drug-related deaths and how to respond to an overdose, and (2) increase the supply of THN. The aim of this study was to assess the effect of the campaign on the supply of THN. METHODS We used an interrupted time series design to assess the effect of the HTSAL mass media campaign on the national community supply of THN. The study time period was August 2020-December 2021. We modelled two key dates: the start of the campaign (week beginning (w/b) 30th of August 2021) and after the end of the main campaign (w/b 25th of October 2021). RESULTS The total number of THN kits distributed in the community in Scotland during the study period was 27,064. The mean number of THN kits distributed per week (relative to the pre-campaign period), increased by 126% during the campaign and 57% post-campaign. In segmented regression analyses, the pre-campaign trend in the number of THN kits supplied was increasing by an average of 1% each week (RR=1.01, 95% CI 1.01 to 1.01, p<0.001). Once the campaign started, a significant change in level was observed, and the number of kits increased by 75% (RR=1.75, 95% CI 1.29 to 2.40, p<0.001). The trend during the campaign was stable (i.e. not increasing or decreasing) but a significant change in level was observed when the campaign ended, and the number of THN kits supplied decreased by 32% (RR=0.68, 95% CI 0.46 to 0.98, p = 0.042). The trend during the post-campaign period was stable. CONCLUSIONS The HTSAL campaign had a short term, but large and significant impact, on the community supply of THN in Scotland. Mass media campaigns could be combined with other interventions and strategies to maintain the increased uptake of THN outside of campaign periods.
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Affiliation(s)
- Kma Trayner
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Public Health Scotland, Glasgow, UK.
| | - A Yeung
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Public Health Scotland, Glasgow, UK
| | - H R Sumnall
- Liverpool John Moores University, Liverpool, UK
| | | | - M E Glancy
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Public Health Scotland, Glasgow, UK
| | - A Atkinson
- Liverpool John Moores University, Liverpool, UK
| | - M Smith
- Public Health Scotland, Glasgow, UK
| | - A McAuley
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Public Health Scotland, Glasgow, UK
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Kiefer L, Chiosso A, Langen J, Buckley A, Gaudin S, Rajkumar SM, Servito GIF, Cha ES, Vijay A, Yeung A, Horta A, Mui MH, Canzio D. WAPL functions as a rheostat of Protocadherin isoform diversity that controls neural wiring. Science 2023; 380:eadf8440. [PMID: 37347873 DOI: 10.1126/science.adf8440] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 11/17/2022] [Accepted: 05/07/2023] [Indexed: 06/24/2023]
Abstract
Neural type-specific expression of clustered Protocadherin (Pcdh) proteins is essential for the establishment of connectivity patterns during brain development. In mammals, deterministic expression of the same Pcdh isoform promotes minimal overlap of tiled projections of serotonergic neuron axons throughout the brain, while stochastic expression of Pcdh genes allows for convergence of tightly packed, overlapping olfactory sensory neuron axons into targeted structures. How can the same gene locus generate opposite transcriptional programs that orchestrate distinct spatial arrangements of axonal patterns? Here, we reveal that cell type-specific Pcdh expression and axonal behavior depend on the activity of cohesin and its unloader, WAPL (wings apart-like protein homolog). While cohesin erases genomic-distance biases in Pcdh choice, WAPL functions as a rheostat of cohesin processivity that determines Pcdh isoform diversity.
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Affiliation(s)
- Lea Kiefer
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Anna Chiosso
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Jennifer Langen
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
- Neuroscience Graduate Program, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Alex Buckley
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
- Neuroscience Graduate Program, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Simon Gaudin
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
- Ecole Normale Superieure de Lyon, 69432 Lyon, France
| | - Sandy M Rajkumar
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Gabrielle Isabelle F Servito
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Elizabeth S Cha
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Akshara Vijay
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Albert Yeung
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Adan Horta
- Pura Vida Investments, New York, NY 10106, USA
| | - Michael H Mui
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Daniele Canzio
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
- Chan-Zuckerberg Biohub, San Francisco, CA 94158, USA
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Yeung A, Sapirstein G, Crain LD, Cramer MA, Forcen FE. Pharmacotherapy and Ketamine Assisted Psychotherapy for Treatment-Resistant Depression: A Patient With Lifelong Self-Doubt and Self-Criticism. J Clin Psychiatry 2023; 84. [PMID: 37022756 DOI: 10.4088/jcp.23ct14798] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Although consensus in the field is lacking, the most common definition for treatment-resistant depression (TRD) requires a minimum of 2 prior treatment failures with confirmed adequate dose and duration. This article presents a clinical example of TRD in a patient with a long history of depression and inadequate response to treatment. The prominent feature is the patient's persistent self-criticism that might have predisposed him to unrelenting depression symptoms, intense anger, self-doubt, and self-disapproval. We explore potential underlying causes for self-criticism, its impact on depression and help-seeking, and plausible treatment approaches.
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Affiliation(s)
- Albert Yeung
- Depression Clinical & Research Program, Massachusetts General Hospital, Boston, Massachusetts
- Corresponding author: Albert Yeung, MD, ScD, Massachusetts General Hospital, 6F, Bowdoin Sq, Boston, MA 02114
| | | | - Laura D Crain
- Center for Group Psychotherapy, Massachusetts General Hospital, Boston, Massachusetts
| | - Margaret A Cramer
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts eCenter for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts
| | - Fernando Espi Forcen
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts eCenter for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts
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Huang H, Liu Z, Xiong H, Herold F, Kuang J, Chen E, Taylor A, Yeung A, Sun J, Hossain MM, Kramer A, Guo T, Zou L. Validation of sociocultural attitudes towards appearance questionnaire and its associations with body-related outcomes and eating disorders among Chinese adolescents. Front Psychiatry 2023; 14:1088769. [PMID: 36993923 PMCID: PMC10041934 DOI: 10.3389/fpsyt.2023.1088769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/03/2023] [Indexed: 03/14/2023] Open
Abstract
IntroductionThe Sociocultural Attitudes Towards Appearance Questionnaire-4 Revised (SATAQ-4R) has been widely used in Western countries to link body appearance that is related to eating disorders and body dissatisfaction being commonly reported by adolescents. However, a comprehensive psychometric validation of the SATAQ-4R in Chinese adolescent samples is still lacking. To this end, the aim of the current study was to validate the gender-appropriate SATAQ-4R in a sample of Chinese adolescents, following by an investigation of its associations with body-related outcomes and eating disorder symptoms.MethodsTwo gender-specific studies were conducted to examine the psychometric properties of the SATAQ-4R-Female and SATAQ-4R-Male respectively among adolescent girls (Study1, N=344, with 73 participants at retest) and boys (Study2, N=335, with 64 participants at retest). Confirmatory factor analysis was employed to examine the factor structure and their test-retest reliability, the internal consistency and convergent validity were subsequently examined.ResultsFor the SATAQ-4R-Females, the seven-factor model has a reasonable fit, with Chi-square =1112.769 (p < 0.001), CFI = 0.91, RMSEA = 0.071, SRMR = 0.067. For the SATAR-4R-Males, an acceptable seven-factor model with Chi-square = 982.92 (p<0.001), CFI = 0.91, RMSEA = 0.08, SRMR= 0.06 was observed. With respect to test-retest reliability, the internal consistency for 7 subscales was rated as good (Cronbach’s alpha =0.74 to 0.95) among female adolescents, likewise the internal consistency of the seven subscales was also rated as good (Cronbach’s alpha =0.70 to 0.96) among male participants. Good convergent validity was observed, reflected by associations of the subscales of the gender-specific SATAQ-4R with muscularity-related attitude, body image-acceptance, body appearance, perceived stress level, symptoms of eating disorder and self-esteem.DiscussionFor women and men, the original 7-factor structure was validated among Chinese adolescents, internal reliability coefficients for the seven subscale scores were good and test-retest reliability was acceptable. Our results also confirmed the convergent validity of the two different gender-appropriate scales.
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Affiliation(s)
- Houyi Huang
- Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Zhongting Liu
- Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Haoran Xiong
- Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Jin Kuang
- Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Erle Chen
- Shenzhen College of International Education, Shenzhen, China
| | - Alyx Taylor
- AECC University College, School of Rehabilitation, Sport and Psychology, Bournemouth, United Kingdom
| | - Albert Yeung
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States
| | - Jing Sun
- School of Medicine and Dentistry and Menzies Health Institute Queensland, Griffith University, Birtinya, QLD, Australia
| | - Md M. Hossain
- Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, Houston, TX, United States
- Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, United States
| | - Arthur Kramer
- Center for Cognitive & Brain Health, Northeastern University, Boston, MA, United States
- Beckman Institute, University of Illinois, Champaign, IL, United States
| | - Tianyou Guo
- Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
- *Correspondence: Tianyou Guo,
| | - Liye Zou
- Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
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Yeung A, Cetinkaya D, Mischoulon D. Cultural Issues in the Management of Depression Among Chinese Americans. Psychiatr Ann 2023. [DOI: 10.3928/00485713-20230214-02] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Yeung A. Reconceptualizing Mental Health Care to Better Help Racial/Ethnic Minorities. Psychiatr Ann 2023. [DOI: 10.3928/00485713-20230216-01] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Yang FC, Zamaria J, Morgan S, Lin E, Leuchter AF, Abrams M, Chang SE, Mischoulon D, Pedrelli P, Fisher L, Nyer M, Yeung A, Jain FA. How family dementia caregivers perceive benefits of a 4-week Mentalizing Imagery Therapy program: a pilot study. Prof Psychol Res Pr 2022; 53:494-503. [PMID: 36212803 PMCID: PMC9540433 DOI: 10.1037/pro0000388] [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: 11/07/2022]
Abstract
Background Family caregivers of dementia patients experience high levels of interpersonal stress that often results in elevated anxiety, and depression, and negative impacts on interpersonal relationships. Changes in behaviors and the structure of relationships with the care recipient (CR) and others in the social milieu challenge the caregivers' ability to mentalize, or understand the links between mental states and behaviors. This study investigates the experiences and perceived benefits of family dementia caregivers who underwent Mentalizing Imagery Therapy (MIT), a treatment aiming to improve balanced self-other mentalizing and reduce psychological symptoms. Methods Purposeful sampling was used to select 11 family dementia caregivers who underwent a 4-week pilot trial of MIT. Semi-structured interviews were completed post-intervention to identify subjective benefits, putative psychological mediators and perceived active components. Results Caregivers reported improvements in well-being, mood, anxiety, and sleep, and a majority stated MIT helped with forming and maintaining healthier relationships. Some participants noted benefits extending to how they reacted to their social environment and perceived themselves more objectively from others' perspectives. Specific elements of MIT, including self-compassion, self-care, and the ability to reflect on emotionally arousing challenges, might have mediated these improvements. Conclusion Family dementia caregivers perceived salutary benefits of MIT on multiple domains of well-being. The self reports suggest MIT holds promise for improving well-being, reducing non-mentalizing patterns of thought, and facilitating improvements in balanced mentalization within the caregivers' relationships.
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Affiliation(s)
| | - Joseph Zamaria
- Department of Psychiatry, University of California, San Francisco, CA
| | - Stefana Morgan
- Department of Psychiatry, University of California, San Francisco, CA
| | - Eric Lin
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry, University of California, Los Angeles, CA
| | - Andrew F. Leuchter
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry, University of California, Los Angeles, CA
| | - Michelle Abrams
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry, University of California, Los Angeles, CA
| | - Sarah E. Chang
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry, University of California, Los Angeles, CA
| | - David Mischoulon
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Paola Pedrelli
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Lauren Fisher
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Maren Nyer
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Albert Yeung
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Felipe A. Jain
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Wu D, Yang T, Herold F, Hall DL, Mueller N, Yeung A, Kramer AF, Guo T, Zou L. Validation of the 4-Item and 10-Item Uncertainty Stress Scale in a Community-Based Sample of Chinese Adults. Psychol Res Behav Manag 2022; 15:2803-2813. [PMID: 36193332 PMCID: PMC9526474 DOI: 10.2147/prbm.s379180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/20/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose The objectives of this study were to examine the psychometric properties of the Uncertainty Stress Scale (USS) and to compare the usefulness of two versions of the scale (USS-4 and USS-10) among a large community-based sample of Chinese adults. Participants and Methods The Uncertainty Stress Scale was validated in 904 community residents (mean age: 32.71 ± 10.99; male: 41.7%) through an online survey conducted in February 2020. Psychometric properties of reliability (Cronbach’s alpha), construct validity (confirmatory factor analysis), and criterion validity (correlation and ROC curve analyses) were evaluated using established benchmarks. To validate the USS, we used the Chinese version of the Perceived Stress Scale (CPSS). In addition, sensitivity, specificity, and suitable cutoff values of the two versions of USS were determined. Results Both versions of the USS had high internal consistency (USS-10: 0.941; USS-4: 0.851). Confirmatory factor analyses supported a one-factor structure for both measures. Both USS-4 and USS-10 scores were significantly positively correlated with CPSS scores, indicating acceptable criterion validity. Conclusion The findings of the current study confirmed that the psychometric properties of two Chinese versions of USS are acceptable. Furthermore, the 4-item USS was as effective as the 10-item USS for the measurement of uncertainty stress in our community-based sample of Chinese adults suggesting that the USS-4 is a time-efficient alternative to the USS-10 which can be used when the circumstances require a time-efficient instrument (eg, in epidemiological studies with a large test battery).
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Affiliation(s)
- Dan Wu
- Body-Brian-Mind Laboratory, School of Psychology/The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen, 518060, People’s Republic of China
| | - Tingzhong Yang
- Women’s Hospital/Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, 310058, People’s Republic of China
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, 14476, Germany
| | - Daniel L Hall
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Mongan Institute, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Notger Mueller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, 14476, Germany
| | - Albert Yeung
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Arthur F Kramer
- Beckman Institute, University of Illinois, Urbana, IL, 61801, USA
- Center for Cognitive & Brain Health, Northeastern University, Boston, MA, 02115, USA
| | - Tianyou Guo
- Body-Brian-Mind Laboratory, School of Psychology/The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen, 518060, People’s Republic of China
- Correspondence: Tianyou Guo, Body-Brian-Mind Laboratory, School of Psychology/The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen, Guangdong, 518060, People’s Republic of China, Email
| | - Liye Zou
- Body-Brian-Mind Laboratory, School of Psychology/The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen, 518060, People’s Republic of China
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11
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Iosifescu DV, Norton RJ, Tural U, Mischoulon D, Collins K, McDonald E, De Taboada L, Foster S, Cusin C, Yeung A, Clain A, Schoenfeld D, Hamblin MR, Cassano P. Very Low-Level Transcranial Photobiomodulation for Major Depressive Disorder: The ELATED-3 Multicenter, Randomized, Sham-Controlled Trial. J Clin Psychiatry 2022; 83. [PMID: 35950904 DOI: 10.4088/jcp.21m14226] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Background: Transcranial photobiomodulation (t-PBM) with near-infrared (NIR) light might represent a treatment for major depressive disorder (MDD). However, the dosimetry of administered t-PBM varies widely. We tested the efficacy of t-PBM with low irradiance, low energy per session, and low number of sessions in individuals with MDD. Methods: A 2-site, double-blind, sham-controlled study was conducted of adjunct t-PBM NIR (830 nm; continuous wave; 35.8 cm2 treatment area; 54.8 mW/cm2 irradiance; 65.8 J/cm2 fluence, 20 min/session; ~2 W total power; 2.3 kJ total energy per session), delivered to the prefrontal cortex, bilaterally, twice a week for 6 weeks, in subjects diagnosed with MDD per the DSM-IV criteria. Subjects were recruited between August 2016 and May 2018. A sequential parallel comparison design was used: 18 nonresponders to sham in phase 1 (6 weeks) were re-randomized in phase 2. The primary outcome was reduction in depression severity (Hamilton Depression Rating Scale [HDRS-17] and Quick Inventory of Depressive Symptomatology-Clinician Rating [QIDS-C] scores) from baseline. Statistical analyses used R package SPCDAnalyze2, including all subjects with ≥ 1 post-randomization evaluation. Results: Of the 54 subjects recruited, we included 49 MDD subjects in the analysis (71% female, mean ± SD age 40.8 ± 16.1 years). There were no significant differences between t-PBM and sham with respect to the change in HDRS-17 (t = -0.319, P = .751) or QIDS-C (t = -0.499, P = .620) scores. The sham effect was reasonably low. Conclusions: Mostly uncontrolled studies suggest the efficacy of t-PBM for MDD; however, its optimal dose is still to be defined. A minimal dose threshold is likely necessary, similarly to other neuromodulation techniques in MDD (electroconvulsive therapy, transcranial magnetic stimulation). We established a threshold of inefficacy of t-PBM for MDD, based on combined low irradiance, low energy per session, and low number of sessions. Trial Registration: ClinicalTrials.gov identifier: NCT02959307.
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Affiliation(s)
- Dan V Iosifescu
- Clinical Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York.,Department of Psychiatry, New York University School of Medicine, New York, New York.,Corresponding author: Dan V. Iosifescu, MD, MSc, Nathan Kline Institute, 140 Old Orangeburg Rd, Orangeburg, NY 10962
| | - Richard J Norton
- Department of Psychological Science, University of Vermont, Burlington, Vermont
| | - Umit Tural
- Clinical Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Katherine Collins
- Clinical Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
| | - Erin McDonald
- Clinical Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
| | | | - Simmie Foster
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Cristina Cusin
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Alisabet Clain
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - David Schoenfeld
- Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts.,Department of Public Health, Harvard Medical School, Boston, Massachusetts
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Johannesburg, South Africa
| | - Paolo Cassano
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Division of Neuropsychiatry, Massachusetts General Hospital, Boston, Massachusetts
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12
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Yeung A, Mischoulon D. Effects of Electroacupuncture for Depression-Related Insomnia. JAMA Netw Open 2022; 5:e2220573. [PMID: 35797050 DOI: 10.1001/jamanetworkopen.2022.20573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston
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13
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Yeung A, Balfoussia D, Rattos A, Salim R. P-402 The association between embryo morphology and first trimester miscarriage after single blastocyst transfer. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.379] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Can standard morphological assessment of blastocyst quality accurately predict first trimester miscarriage?
Summary answer
Decreasing trophectoderm and inner cell mass grade equally predicted first trimester miscarriage independently. After adjusting for confounders, poor embryo quality was not associated with miscarriage.
What is known already
Embryo quality determined by morphological assessment is a well-established predictor of successful implantation and live birth with in vitro fertilization treatment. Chromosomal abnormalities account for over half of first trimester miscarriages, and links between ploidy status and embryo morphology have been demonstrated. However, the association between blastocyst morphology and first trimester miscarriage is still poorly understood with consensus opinion yet to be established.
Study design, size, duration
This single centre retrospective cohort study included 2020 fresh and frozen single embryo transfers between October 2010 and October 2020. Blastocyst degree of expansion, inner cell mass (ICM) grade, and trophectoderm (TE) grade were compared for 354 pregnancies ending in first trimester miscarriage and 1666 pregnancies that surpassed 12 weeks of gestation. The association between blastocyst morphology and miscarriage was examined by logistic regression analysis.
Participants/materials, setting, methods
All single blastocyst transfers over a 10-year period resulting in first trimester miscarriage or pregnancy beyond 12 weeks of gestation were included in our analysis. Cycles involving donor oocytes, preimplantation genetic testing, resulting in biochemical pregnancy, or ectopic pregnancy were excluded. Differences between groups were analysed with chi-square and logistic regression analysis. Odds ratios (aOR) for miscarriage versus ongoing pregnancy were adjusted for maternal age, cycle type, blastocyst expansion, ICM grade, and TE grade.
Main results and the role of chance
Out of 2020 single embryo transfer cycles, a total of 354 resulted in first trimester miscarriage (17.5%). Independently, miscarriage rates increased with decreasing ICM grade (A to C; 14.6%, 18.9%, and 26.5%, p = 0.003) and TE grade (A to C; 14.6%, 17.7%, and 26.6%, p = 0.004). Univariate logistic regression showed higher risks of miscarriage with ICM grade C compared to ICM grade A (OR 2.241, 95%CI 1.292-3.886, p = 0.004), TE grade C compared to TE grade A (OR 2.116, 95%CI 1.360 – 3.292, p = 0.001), and expansion grades of 1 and 2 compared to expansion of 5 and 6 (OR 2.514, 95%CI 1.477 – 4.278, p = 0.001). After multivariable logistic regression adjusting for maternal age at embryo transfer, cycle type, and all morphological parameters (degree of expansion, ICM, and TE), only expansion grade of 1 and 2 showed a statistically significant association with first trimester miscarriage.
Limitations, reasons for caution
The main limitation of this study is the retrospective design of the analysis, and subjective nature of embryo morphological assessment. There may also be residual confounding by unknown or unmeasured confounders such as paternal age or maternal BMI.
Wider implications of the findings
Embryo selection for transfer should continue to be guided by standard morphological assessment. Decreasing grade of ICM and TE are both positively associated with an increased miscarriage risk, while poorly expanded blastocysts are most predictive of first trimester miscarriage. Patients undergoing embryo transfer should be adequately counselled about these risks.
Trial registration number
Not applicable
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Affiliation(s)
- A Yeung
- Imperial College Healthcare NHS Trust, Reproductive Medicine , London, United Kingdom
| | - D Balfoussia
- Imperial College Healthcare NHS Trust, Reproductive Medicine , London, United Kingdom
| | - A Rattos
- Imperial College Healthcare NHS Trust, Reproductive Medicine , London, United Kingdom
| | - R Salim
- Imperial College Healthcare NHS Trust, Reproductive Medicine , London, United Kingdom
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14
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Balfoussia D, Yeung A, Yamanouchi L, Rattos A, Salim R. P-282 Blastocyst transfer in advanced maternal age: Single versus double embryo transfer. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.271] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Is there a role for elective single blastocyst transfer (eSBT) in advanced maternal age?
Summary answer
Double blastocyst transfer (DBT) versus eSBT resulted in higher live birth rates except for those undergoing their first cycle.
What is known already
Women with advanced maternal age are generally considered poorer prognosis patients with lower live birth rates compared to their younger counterparts. This often results in a higher likelihood of double embryo transfer in this group. This is not without risk as multiple pregnancy is associated with significant maternal and neonatal morbidity especially with advancing maternal age. In older women with blastocysts available for transfer, it is unclear who should be recommended double versus elective single transfer. The concept of the “good-prognosis” older woman remains elusive.
Study design, size, duration
This was a retrospective observational study looking at 511 IVF/ICSI cycles between January 2010 and January 2020. Treatment cycle details and clinical outcomes were entered prospectively into a dedicated clinic database. Data was retrieved and analysed using SPSS V25.
Participants/materials, setting, methods
The study was conducted in a large London IVF centre. Data was collected on women aged 40 or above undergoing an IVF/ICSI cycle with eSBT (Group 1, n = 79) or DBT (Group 2, n = 430). Women with more than three previous IVF attempts were excluded. eSBT was defined as a single blastocyst transfer with at least one further blastocyst available for cryopreservation. Subgroup analysis was performed for those undergoing their first cycle.
Main results and the role of chance
Data from 511 cycles was analysed. The mean age was 40.6±1.2years. The live birth rate was 27%. Group 1 was marginally younger (40.2±0.6 v 40.8±1.2, p < 0.005) and was more likely to be undergoing their first IVF cycle (84% v 68%, p = 0.003). Those in Group 1 had more eggs collected (13.6±7.3 v 11.3±5.5, p = 0.009), more zygotes (8.9±4.7 v 7.3±3.6) formed and more blastocysts frozen (3.4±2.6 v 1.1±1.7, p < 0005). More women in Group 1 had a top quality blastocyst (expansion of > 2 and inner cell mass and trophectoderm of AA, AB, BA or BB) transfer (91% v 71%, p < 0.005).
After logistic regression controlling for maternal age, number of previous IVF cycles and blastocyst quality, Group 1 had a lower likelihood of livebirth (aOR 0.550, 95%CI 0.306-0.988) but with a significantly lower multiple pregnancy rate (0% v 24%, p = 0.024).
Importantly, for those undergoing their first IVF cycle (n = 359), there was no difference in live birth rate in the two groups (aOR 0.617, 95%CI 0.329-1.156) after controlling for age and blastocyst quality but Group 2 had a higher multiple pregnancy rate (24% v 0%, p = 0.020).
Limitations, reasons for caution
This study is limited by its retrospective nature putting it at risk of information bias as it relied on accurate documentation of studied variables into the patient database. The study did not examine cumulative birth rates of fresh and subsequent frozen cycles in Group 1.
Wider implications of the findings
Women should have individualised counseling about number of blastocysts to transfer taking into account their circumstances. Those undergoing their first IVF attempt and with a blastocyst available for transfer, should be counselled that DBT is associated with a higher multiple pregnancy rate with no increase in overall live birth rate.
Trial registration number
Not Applicable
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Affiliation(s)
- D Balfoussia
- Imperial College Healthcare NHS Trust, Wolfson Fertility Centre- Hammersmith Hospital , London, United Kingdom
| | - A Yeung
- Imperial College Healthcare NHS Trust, Wolfson Fertility Centre- Hammersmith Hospital , London, United Kingdom
| | - L Yamanouchi
- Imperial College Healthcare NHS Trust, Hammersmith Hospital , London, United Kingdom
| | - A Rattos
- Imperial College Healthcare NHS Trust, Wolfson Fertility Centre- Hammersmith Hospital , London, United Kingdom
| | - R Salim
- Imperial College Healthcare NHS Trust, Wolfson Fertility Centre- Hammersmith Hospital , London, United Kingdom
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15
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Al Ahmad J, Norman S, Tierney M, Hansen T, Lee A, Shetty P, Yeung A, Danson E, Nguyendang T, Owensby D. 10 Years of ST Elevation Myocardial Infarctions (STEMIs) in the Illawarra Shoalhaven Local Health District (ISLHD) – Patient Demographics. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.554] [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: 11/30/2022]
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16
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Jain FA, Chernyak SV, Nickerson LD, Morgan S, Schafer R, Mischoulon D, Bernard-Negron R, Nyer M, Cusin C, Ramirez Gomez L, Yeung A. Four-Week Mentalizing Imagery Therapy for Family Dementia Caregivers: A Randomized Controlled Trial with Neural Circuit Changes. Psychother Psychosom 2022; 91:180-189. [PMID: 35287133 PMCID: PMC9064903 DOI: 10.1159/000521950] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/03/2022] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Family caregivers of patients with dementia suffer a high burden of depression and reduced positive emotions. Mentalizing imagery therapy (MIT) provides mindfulness and guided imagery skills training to improve balanced mentalizing and emotion regulation. OBJECTIVE Our aims were to test the hypotheses that MIT for family caregivers would reduce depression symptoms and improve positive psychological traits more than a support group (SG), and would increase dorsolateral prefrontal cortex (DLPFC) connectivity and reduce subgenual anterior cingulate cortex (sgACC) connectivity. METHODS Forty-six caregivers participated in a randomized controlled trial comparing a 4-week MIT group (n = 24) versus an SG (n = 22). Resting state neuroimaging was obtained at baseline and post-group in 28 caregivers, and questionnaires completed by all participants. The primary outcome was change in depression; secondary measures included anxiety, mindfulness, self-compassion, and well-being. Brain networks with participation of DLPFC and sgACC were identified. Connectivity strengths of DLPFC and sgACC with respective networks were determined with dual regression. DLPFC connectivity was correlated with mindfulness and depression outcomes. RESULTS MIT significantly outperformed SG in improving depression, anxiety, mindfulness, self-compassion, and well-being, with moderate to large effect sizes. Relative to SG, participants in MIT showed significant increases in DLPFC connectivity - exactly replicating pilot study results - but no change in sgACC. DLPFC connectivity change correlated positively with mindfulness and negatively with depression change. CONCLUSIONS In this trial, MIT was superior to SG for reducing depression and anxiety symptoms and improving positive psychological traits. Neuroimaging results suggested that strengthening DLPFC connectivity with an emotion regulation network might be mechanistically related to MIT effects.
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Affiliation(s)
- Felipe A Jain
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sergey V Chernyak
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lisa D Nickerson
- Applied Neuroimaging Statistics Laboratory, McLean Hospital, Harvard Medical School, Belmont, Massachusetts, USA
| | - Stefana Morgan
- Weill Institute for Neurosciences and Langley Porter Psychiatric Hospital and Clinics, University of California, San Francisco, California, USA
| | - Rhiana Schafer
- Department of Neurology, Northwestern University, Chicago, Illinois, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Richard Bernard-Negron
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Maren Nyer
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Cristina Cusin
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Liliana Ramirez Gomez
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Albert Yeung
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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17
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Chi X, Chen S, Chen Y, Chen D, Yu Q, Guo T, Cao Q, Zheng X, Huang S, Hossain MM, Stubbs B, Yeung A, Zou L. Psychometric Evaluation of the Fear of COVID-19 Scale Among Chinese Population. Int J Ment Health Addict 2022; 20:1273-1288. [PMID: 33456407 PMCID: PMC7799163 DOI: 10.1007/s11469-020-00441-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [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] [Accepted: 11/13/2020] [Indexed: 01/31/2023] Open
Abstract
Fear is a negative emotional reaction to or persistent worry over an imminent public health event like COVID-19. The COVID-Fear Scale was developed in many countries, but not in China. The current study aims to examine the psychometric properties of Chinese version of the Fear of COVID-19 Scale. Translation into Chinese and back-translation into English were conducted firstly. Item analysis and exploratory factor analysis were conducted in Sample 1, followed by validity tests in Sample 2. Likely, test-retest reliability was conducted in sample 3. A bifactor structure of Chinese version of FCV-19S with a general fear factor and two orthogonal group factors with fear thoughts and physical response was confirmed. Besides, it has good internal consistency reliability (α = .92), composite reliability (CR = .92), and validity correlation validity. The results of the present study confirmed that the Chinese version of FCV-19S has good psychometric properties in the Chinese communities. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-020-00441-7.
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Affiliation(s)
- Xinli Chi
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Shiyun Chen
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Yuying Chen
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Danying Chen
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Qian Yu
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Tianyou Guo
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Qianyu Cao
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Xiaodan Zheng
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Shaojie Huang
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Md Mahhub Hossain
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Liye Zou
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
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18
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Hansen T, Norman S, Al AJ, Tierney M, Nguyendang T, Yeung A, Danson E, Owensby D, Lee A, Shetty P. Single Centre Experience of Primary PCI: 10-Year Procedural Outcomes. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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19
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Zhang J, Luberto CM, Huang Q, Kuang J, Zhong J, Yeung A, Zou L. Validation of the Chinese Version of Relaxation Sensitivity Index: A Tool for Predicting Treatment Effect in Mindfulness Interventions. Front Public Health 2021; 9:809572. [PMID: 34988059 PMCID: PMC8720785 DOI: 10.3389/fpubh.2021.809572] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The Relaxation Sensitivity Index (RSI) measures relaxation-related fears developed and validated in western samples. The RSI captures three facets of fear regarding relaxation: physical, cognitive, and social concerns. This study aimed to translate and identify the factor structure of the Chinese version of the RSI. Methods: In a preliminary study, 26 items were generated mainly by translation and modified from the original RSI. In Study 1, factor analysis and internal consistency reliability analysis were conducted on separated half samples of 597 Chinese college students. In Study 2, test-retest reliability, convergent, and predictive criterion validity were examined based on 465 Chinese college students. Results: Fourteen items were selected based on the factor loading and item prevalence in the preliminary study. Factor analysis based on Study 1 identified three factors: Social appealing, Social performance, and Physical concerns. In general, the RSI demonstrated good internal consistency (αs = 0.750-0.860), convergent validity and predictive criterion validity, while the test-retest reliability is relatively low (rs = 0.525-0.685). Notably, less related to the other two factors, Social performance concerns may be a unique factor solely predicting social anxiety (p <0.001), but not relaxation-induced anxiety (p = 0.442). Conclusion: The Chinese version of the RSI possesses a factor structure different from the western population. The robustness of factor structure and test-retest reliability was not as good as expected. Further research is warranted to explore the validity of the RSI in Chinese samples.
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Affiliation(s)
- Jieting Zhang
- Department of Psychology, Shenzhen University, Shenzhen, China
- Institution for Mental Health, Shenzhen University, Shenzhen, China
| | - Christina M. Luberto
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Qi Huang
- Department of Psychology, Shenzhen University, Shenzhen, China
| | - Jin Kuang
- Department of Psychology, Shenzhen University, Shenzhen, China
| | - Juan Zhong
- Springfield College, Springfield, MA, United States
| | - Albert Yeung
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Liye Zou
- Department of Psychology, Shenzhen University, Shenzhen, China
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, China
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Grewal R, Deeks SL, Hart TA, Cox J, De Pokomandy A, Grennan T, Lambert G, Moore D, Coutlée F, Gaspar M, George C, Grace D, Jollimore J, Lachowsky NJ, Nisenbaum R, Ogilvie G, Sauvageau C, Tan DHS, Yeung A, Burchell AN. Human papillomavirus (HPV) vaccination across a cascade of knowledge, willingness, and uptake among gay, bisexual, and other men who have sex with men in Canada's three largest cities. Hum Vaccin Immunother 2021; 17:5413-5425. [PMID: 34856869 DOI: 10.1080/21645515.2021.1979379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Some Canadian jurisdictions offer publicly funded HPV vaccine to gay, bisexual, and other men who have sex with men (GBM) aged ≤26 years. We characterized factors associated with being in different stages of HPV vaccination. METHODS Engage is a sexual health study of GBM in the three largest Canadian cities recruited via respondent driven sampling (RDS). We categorized participants as: (1) unaware of HPV vaccine, (2) undecided/unwilling to get vaccinated, (3) willing to get vaccinated, (4) vaccinated with one or more doses. Our RDS-II weighted analyses used multinomial logistic regression to identify factors associated with being in earlier stages of the cascade compared to Stage 4. RESULTS Across the cities, 26-40%, 7-14%, 33-39%, and 13-28% were in Stages 1 to 4, respectively. Compared to Stage 4, being in earlier stages of the cascade was associated with bisexual-identification (Stage 1: adjusted odds ratio[aOR] = 2.84, 95% confidence interval[CI] = 1.06-7.62; Stage 2: aOR = 3.09, 95%CI = 1.19-8.05), having immigrated to Canada (Stage 1: aOR = 1.79, 95%CI 1.07-2.99), preference to keep same-sex romantic relationships private (Stage 1: aOR = 1.25, 95% CI = 1.05-1.48; Stage 2: aOR = 1.24, 95%CI = 1.05-1.46), not receiving sexual health information (Stage 1: aOR = 0.31, 95% CI = 0.13-0.71; Stage 2: aOR = 0.27, 95%CI = 0.12-0.64), not accessing a health-care provider (Stage 2: aOR = 0.36, 95%CI = 0.15-0.83), and no past hepatitis A/B vaccination (Stage 1: aOR = 0.16, 95% CI = 0.09-0.30; Stage 2: aOR = 0.18, 95%CI = 0.09-0.35; Stage 3: aOR = 0.38, 95%CI = 0.21-0.61). DISCUSSION Interventions are needed to reduce social and financial barriers, increase sexual health knowledge, and improve GBM-competent health-care access to increase vaccine uptake among GBM.
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Affiliation(s)
- R Grewal
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - S L Deeks
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Nova Scotia Department of Health and Wellness, Halifax, Canada
| | - T A Hart
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Psychology, Ryerson University, Toronto, Canada
| | - J Cox
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, Montréal, McGill University.,Direction régionale de santé publique, CIUSSS-Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
| | - A De Pokomandy
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
| | - T Grennan
- BC Centre for Disease Control, Provincial Health Services Authority, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
| | - G Lambert
- Direction régionale de santé publique, CIUSSS-Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
| | - D Moore
- Department of Medicine, University of British Columbia, Vancouver, Canada.,BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - F Coutlée
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, Canada.,Department of Microbiology and Immunology, Université de Montréal, Montréal, Canada
| | - M Gaspar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - C George
- Department of Exercise, Health, and Sport Sciences, University of Maine, Portland, USA
| | - D Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - J Jollimore
- Community-Based Research Centre, Vancouver, Canada
| | - N J Lachowsky
- BC Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Community-Based Research Centre, Vancouver, Canada.,School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - R Nisenbaum
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Applied Health Research Centre, Unity Health Toronto, Toronto, Canada
| | - G Ogilvie
- BC Centre for Disease Control, Provincial Health Services Authority, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - C Sauvageau
- Faculty of Medicine, Université Laval, Québec City, Canada.,Institut National de santé publique du Québec, Québec, Canada
| | - D H S Tan
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - A Yeung
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada
| | - A N Burchell
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, Canada
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21
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Yeung A, Chen Y, Feng F, Zhou W, Goodness T, Wang F, Liu T. Use of the Move to Emptiness Technique, A Mind-Body Exercise for Treating Trauma and Post-Traumatic Stress Disorder: A Case Report. Adv Mind Body Med 2021; 35:9-11. [PMID: 34734844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
CONTEXT The paper reports a case of trauma treated by the Move to Emptiness Technique (MET), which is a therapy to alleviate patient's physical or psychological symptom related to trauma by combining Qigong with imagery, metaphor and suggestions. OBJECTIVE To introduce MET and report treating a patient with trauma using MET. INTERVENTION The patient was guided to visualize a symbolic object that represented the physical or psychological symptom of the traumatic experience, and visualize moving the symbolic object to the farthest possible space of "emptiness", where the object became imperceptible. At the same time, the patient embodied the physical and emotional sensations of the symbolic object and its container, and focused on the changes in his sensations when moving them. OUTCOME MEASURES A self-assessment was used to score the patient's distress form 0 to 10, 10 being the worst before and after intervention. RESULTS The score of distress dropped form 8/10 to 2/10. The patient improved a lot and was better able to manage his emotions and communicate with his parents after resolving his conflict. CONCLUSIONS MET may be an alternative to commonly used trauma-focused treatments. It is safe and easy to learn for therapists and patients.
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22
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Lin J, Zou L, Lin W, Becker B, Yeung A, Cuijpers P, Li H. Does gender role explain a high risk of depression? A meta-analytic review of 40 years of evidence. J Affect Disord 2021; 294:261-278. [PMID: 34304081 DOI: 10.1016/j.jad.2021.07.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 01/02/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND This meta-analytic review aimed to systematically evaluate associations of depression with multiple gender role dimensions (masculinity, femininity, androgyny, and undifferentiated traits) and to determine potential moderators (participant characteristics, study instruments and sociocultural factors) of the relationship. METHODS Of 4481 initially identified records in three electronic databases, 58 studies published 1978 to 2021 were included for meta-analysis. RESULTS (1) Association of depression and gender role is moderated by study year and human development indices. (2) Masculinity is a protective factor for depression, while this dominance has declined as life expectancy increases. (3) A negative, weak but significant association between depression and femininity is observed in women, and college students, which starts to emerge with the gradual increase in the national education and income index from 1990 to 2019. (4) Androgynous individuals reported the lowest level of depression as compared with other gender role orientations (masculine, feminine, and undifferentiated trait group). This disparity is becoming more extreme with life expectancy and per capita income index increases. LIMITATIONS English-language studies were only included in this review. CONCLUSIONS Androgyny might be the most ideal gender role protecting both women and men from depression.
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Affiliation(s)
- Jingyuan Lin
- Center for Brain Function and Psychological Science, Shenzhen University; Shenzhen Institute of Neuroscience, Shenzhen 518060, Guangdong, China; Center for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain Cognition and Educational Science, Ministry of Education; School of Psychology, South China Normal University, Guangzhou 510631, Guangdong, China; Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610054, Sichuan, China
| | - Liye Zou
- Exercise Psychophysiology Laboratory; Institute of KEEP Collaborative Innovation, School of Psychology, Shenzhen University, 518060, China
| | - Wuji Lin
- Center for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain Cognition and Educational Science, Ministry of Education; School of Psychology, South China Normal University, Guangzhou 510631, Guangdong, China; Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610054, Sichuan, China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 610054, Sichuan, China
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, Amsterdam 1081 BT, the Netherlands
| | - Hong Li
- Center for Brain Function and Psychological Science, Shenzhen University; Shenzhen Institute of Neuroscience, Shenzhen 518060, Guangdong, China; Center for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain Cognition and Educational Science, Ministry of Education; School of Psychology, South China Normal University, Guangzhou 510631, Guangdong, China; Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610054, Sichuan, China.
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23
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Yeung A, Xie Q, Huang X, Hoeppner B, Jain FA, Tan EK, Mai X, Mischoulon D, Guo X. Effectiveness of Mindful Self-Compassion Training Supported by Online Peer Groups in China: A Pilot Study. Altern Ther Health Med 2021:AT6940. [PMID: 34559687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
CONTEXT Self-compassion training involves the cultivation of feelings of warmth and safety, presence, and interconnectedness. Mindful Self-Compassion (MSC) training in a group setting has been found to increase self-compassion, mindfulness, and emotional well-being. OBJECTIVE The current study intended to examine the outcomes of live, online, videoconference-based MSC training with online peer-support for nonclinical populations in different cities in China. DESIGN The research team designed a pre-post pilot study. SETTING The study took place at Renmin University in Beijing, China. PARTICIPANTS Participants were 253 Chinese individuals who were recruited from different regions in China through online advertisements. INTERVENTION Participants took part in online MSC training in a two-hour, group class each week for eight weeks and received support from online peer groups and through a half-day in-person retreat. OUTCOME MEASURES Self-report outcomes were obtained at baseline and postintervention, using the Self Compassion Scale (SCS) and the Compassion for Others Scale (CS) for primary outcomes, and the Depression, Anxiety, and Stress Scale (DASS-21), the Fear of Compassion Scale (FOCS), the Satisfaction with Life Scale (SWLS), the Subjective Happiness Scale (SHS), and the Cognitive and Affective Mindfulness Scale (CAMS-R), for secondary outcomes. A fixed effects model was used to test for within-group changes in the scales. RESULTS The online MSC program yielded a high retention rate. Of the 206 first-time participants, 179 (86.9%) attended six or more of the eight MSC sessions, and 183 (88.8%) completed the assessments at both baseline and postintervention. Of the 183 retained participants, 97.8% were female, with an average age of 37.8 ± 7.9; 94% had college or higher education. For all scales, the within-person changes occurred in the expected direction; positive attributes and experiences increased, while negative attributes and experiences decreased. CONCLUSIONS The study showed that first-time participants in China in an online MSC training that was supported by online peer groups had high attendance rates, high assessment completion, and favorable results. These preliminary outcomes suggest that future studies with more rigorous designs are warranted to further investigate online training with peer support as an effective and efficient approach to disseminate MSC training in China.
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24
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Chi X, Liang K, Chen ST, Huang Q, Huang L, Yu Q, Jiao C, Guo T, Stubbs B, Hossain MM, Yeung A, Kong Z, Zou L. Mental health problems among Chinese adolescents during the COVID-19: The importance of nutrition and physical activity. Int J Clin Health Psychol 2021; 21:100218. [PMID: 33391373 PMCID: PMC7759093 DOI: 10.1016/j.ijchp.2020.100218] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/16/2020] [Indexed: 12/26/2022] Open
Abstract
Mental health problems are common among adolescents and greatly influenced by stressful events. This study sought to assess the prevalence and correlates of insomnia, depressive and anxiety symptoms among Chinese adolescents during the COVID-19. METHOD Cross-sectional study (N = 1,794 adolescents, mean age = 15.26) was conducted in May 2020. An online survey was used to collect socio-demographic data, COVID-related fear (COVID-fear), nutrition, physical activity (PA) level and the symptoms of insomnia, depression and anxiety. RESULTS The prevalence of insomnia, depressive and anxiety symptoms was 37.80%, 48.20% and 36.70%, respectively, among Chinese adolescents during the pandemic. Generalized linear models revealed that female, left behind children, and students with greater COVID-fear tended to report symptoms of insomnia, depression and anxiety concurrently. After adjusting for socio-demographic factors and COVID-fear, better nutritional status and moderately active PA were both associated with lower levels of depressive and anxiety symptoms, while highly active PA was associated with lower levels of insomnia, depressive and anxiety symptoms. CONCLUSIONS These findings suggest that more attention should be paid to psychological health among adolescents while combating COVID-19. To promote adolescents' mental health, educators should help adolescents develop a healthy lifestyle with balanced diet and regular exercise.
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Affiliation(s)
- Xinli Chi
- Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Kaixin Liang
- Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Australia
| | - Qiaomin Huang
- Institute of Mental Health, School of Psychology, Shenzhen University, China
- Law School of Shenzhen University, China
| | - Liuyue Huang
- Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Qian Yu
- Institute of Mental Health, School of Psychology, Shenzhen University, China
- Exercise & Mental Health Laboratory, School of Psychology, Shenzhen University, China
| | - Can Jiao
- Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Tianyou Guo
- Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, United Kingdom
| | - Md Mahbub Hossain
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, United States American
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, United States American
| | - Zhaowei Kong
- Faculty of Education, University of Macau, China
| | - Liye Zou
- Institute of Mental Health, School of Psychology, Shenzhen University, China
- Exercise & Mental Health Laboratory, School of Psychology, Shenzhen University, China
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25
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Yeung A, Norton R, Dean T, Nagaswami M, Yeung A, Vuky C, Mischoulon D, Borba C. Depressed Chinese Americans present predominantly psychological symptoms: A new trend or different outcomes due to methodological differences? Asian J Psychiatr 2021; 61:102684. [PMID: 34051526 DOI: 10.1016/j.ajp.2021.102684] [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: 02/12/2021] [Revised: 04/23/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
People of Asian cultural origin have been reported to emphasize somatic rather than psychological symptoms when they are depressed. However, a recent study investigated 190 Chinese immigrants with depression in a primary care clinic and reported that they were more likely to report depressed mood, rather than physical symptoms. We performed a qualitative analysis of the chief complaint narratives of 57 Chinese immigrants with major depressive disorder who were referred to a behavioral health clinic. These patients' chief complaints included insomnia, sadness, anxiety, cognition issues, being irritated/annoyed, having low energy/motivation, and stress. Among this population, 70.18 % presented psychological symptoms, 5.26 % presented somatic symptoms, and the remaining 15.8 % presented only neutral symptoms (e.g. 'low energy', 'loss of appetite', and 'insomnia'). Our findings show that depressed Chinese Americans at outpatient clinics present predominantly psychological and not somatic symptoms. This may reflect a new trend of symptoms reporting among Asian Americans with depression.
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Affiliation(s)
- Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, One Bowdoin Square, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; South Cove Community Health Center, USA.
| | - Richard Norton
- Depression Clinical and Research Program, Massachusetts General Hospital, One Bowdoin Square, Boston, MA, 02114, USA
| | - Taquesha Dean
- Depression Clinical and Research Program, Massachusetts General Hospital, One Bowdoin Square, Boston, MA, 02114, USA
| | - Megha Nagaswami
- Depression Clinical and Research Program, Massachusetts General Hospital, One Bowdoin Square, Boston, MA, 02114, USA
| | - Alicia Yeung
- South Cove Community Health Center, USA; Columbia University, School of Nursing, USA
| | - Catherine Vuky
- South Cove Community Health Center, USA; William James College, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, One Bowdoin Square, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Christina Borba
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Boston Medical Center, Department of Psychiatry, USA
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26
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Grewal R, Deeks SL, Hart TA, Cox J, De Pokomandy A, Grennan T, Lambert G, Moore D, Brisson M, Coutlée F, Gaspar M, George C, Grace D, Jollimore J, Lachowsky NJ, Nisenbaum R, Ogilvie G, Sauvageau C, Tan DHS, Yeung A, Burchell AN. Human papillomavirus (HPV) vaccine uptake among a community-recruited sample of gay, bisexual, and other men who have sex with men in the three largest cities in Canada from 2017 to 2019. Vaccine 2021; 39:3756-3766. [PMID: 34074547 DOI: 10.1016/j.vaccine.2021.05.031] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/26/2021] [Accepted: 05/11/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION In 2015/2016, Canada's largest provinces implemented publicly-funded human papillomavirus (HPV) vaccination programs for gay, bisexual, and other men who have sex with men (GBM) ≤ 26 years old. We sought to describe HPV vaccine uptake among GBM and determine barriers and facilitators to vaccine initiation with a focus on healthcare access and utilization. METHODS Engage is a cohort study among GBM aged 16 + years in three Canadian cities recruited from 2017 to 2019 via respondent driven sampling (RDS). Men completed a comprehensive questionnaire at baseline. By publicly-funded vaccine eligibility (≤26 years old = eligible for vaccination, ≥27 years old = ineligible), we described HPV vaccine uptake (initiation = 1 + dose, completion = 3 doses) and explored factors associated with vaccine initiation using Poisson regression. All analyses were weighted with the RDS-II Volz-Heckathorn estimator. RESULTS Across the three cities, 26-35% and 14-21% of men ≤ 26 years and 7-26% and 2-9% of men ≥ 27 years initiated and completed HPV vaccination, respectively. Vaccine initiation was significantly associated with STI/HIV testing or visiting a HIV care specialist in the past six months (≤26: prevalence ratio[PR] = 2.15, 95% confidence interval[CI] 1.06-4.36; ≥27: PR = 2.73, 95%CI 1.14-6.51) and past hepatitis A or B vaccination (≤26: PR = 2.88, 95%CI 1.64-5.05; ≥27: PR = 2.03, 95%CI 1.07-3.86). Among men ≥ 27 years old, vaccine initiation was also positively associated with accessing PrEP, living in Vancouver or Toronto, but negatively associated with identifying as Latin American and increasing age. Vaccine initiation was twice as likely among men ≥ 27 years with private insurance versus no insurance. CONCLUSIONS Sixty-five to 74% of men eligible for publicly-funded vaccine across the three cities remained unvaccinated against HPV by 2019. High vaccine cost may partly explain even lower uptake among men ≥ 27 years old. Men seeking sexual health care were more likely to initiate vaccination; bundling vaccination with these services may help improve HPV vaccine uptake.
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Affiliation(s)
- R Grewal
- Unity Health Toronto, Canada; University of Toronto, Canada
| | - S L Deeks
- University of Toronto, Canada; Public Health Ontario, Canada
| | - T A Hart
- University of Toronto, Canada; Ryerson University, Canada
| | - J Cox
- McGill University, Canada; Direction régionale de santé publique - Montréal, Canada
| | | | - T Grennan
- BC Centre for Disease Control, Canada; University of British Columbia, Canada
| | - G Lambert
- Direction régionale de santé publique - Montréal, Canada
| | - D Moore
- University of British Columbia, Canada; BC Centre for Excellence in HIV/AIDS, Canada
| | | | - F Coutlée
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Canada; Université de Montréal, Canada
| | | | - C George
- University of Southern Maine, United States
| | - D Grace
- University of Toronto, Canada
| | | | - N J Lachowsky
- BC Centre for Excellence in HIV/AIDS, Canada; Community-Based Research Centre, Canada; University of Victoria, Canada
| | - R Nisenbaum
- Unity Health Toronto, Canada; University of Toronto, Canada
| | - G Ogilvie
- BC Centre for Disease Control, Canada; University of British Columbia, Canada
| | - C Sauvageau
- Université Laval, Canada; Institut national de santé publique du Québec, Canada
| | - D H S Tan
- Unity Health Toronto, Canada; University of Toronto, Canada
| | - A Yeung
- Unity Health Toronto, Canada
| | - A N Burchell
- Unity Health Toronto, Canada; University of Toronto, Canada.
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Zou L, Xiao T, Cao C, Smith L, Imm K, Grabovac I, Waldhoer T, Zhang Y, Yeung A, Demurtas J, Veronese N, Ekelund U, Park Y, Yang L. Tai Chi for Chronic Illness Management: Synthesizing Current Evidence from Meta-Analyses of Randomized Controlled Trials. Am J Med 2021; 134:194-205.e12. [PMID: 32946848 DOI: 10.1016/j.amjmed.2020.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 01/09/2023]
Abstract
An umbrella review of systematic reviews and meta-analyses of randomized controlled trials (RCTs) was conducted to evaluate the existing evidence of Tai Chi as a mind-body exercise for chronic illness management. MEDLINE/PubMed and Embase databases were searched from inception until March 31, 2019, for meta-analyses of at least two RCTs that investigated health outcomes associated with Tai Chi intervention. Evidence of significant outcomes (P value < 0.05) was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. This review identified 45 meta-analyses of RCTs and calculated 142 summary estimates among adults living with 16 types of chronic illnesses. Statistically significant results (P value < 0.05) were identified for 81 of the 142 outcomes (57.0%), of which 45 estimates presenting 30 unique outcomes across 14 chronic illnesses were supported by high (n = 1) or moderate (n = 44) evidence. Moderate evidence suggests that Tai Chi intervention improved physical functions and disease-specific outcomes compared with nonactive controls and improved cardiorespiratory fitness compared with active controls among adults with diverse chronic illnesses. Between-study heterogeneity and publication bias were observed in some meta-analyses.
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Affiliation(s)
- Liye Zou
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Tao Xiao
- College of Mathematics and Statistics, Shenzhen University, Shenzhen, China
| | - Chao Cao
- Program in Physical Therapy, Washington University School of Medicine, St Louis, USA
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Kellie Imm
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Thomas Waldhoer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Yin Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Albert Yeung
- Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Jacopo Demurtas
- Primary Care Department, LHT South-East Tuscany, Grosseto, Italy
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, USA; Siteman Cancer Center, Washington University School of Medicine, St Louis, Mo
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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28
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Guo T, Huang L, Hall DL, Jiao C, Chen ST, Yu Q, Yeung A, Chi X, Zou L. The relationship between childhood adversities and complex posttraumatic stress symptoms: a multiple mediation model. Eur J Psychotraumatol 2021; 12:1936921. [PMID: 34249246 PMCID: PMC8245101 DOI: 10.1080/20008198.2021.1936921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Indexed: 12/29/2022] Open
Abstract
Background: There is a growing research literature on complex posttraumatic stress disorder (CPTSD), yet studies that focused on Chinese populations are still limited. Accumulating evidence showed that adverse childhood experiences (ACEs) are associated with a higher likelihood of CPTSD symptoms, but potential mediating roles of self-kindness and self-judgement on the ACEs-CPTSD relationship remain understudied. Objective: The purpose of this study was to first examine the relationship between ACEs and CPTSD among Chinese college students, and then to test the mediating role of self-kindness and self-judgement on the ACEs-CPTSD relationship. Method: The study included 1361 college students for an online survey in May 2020. Demographic variables (e.g. age, gender, having sibling[s] or not, residence, family structure, and subjective socioeconomic status), ACEs, self-compassion (self-kindness and self-judgement subscales), and CPTSD symptoms were assessed. After controlling for demographic variables, a series of structural equation models tested the mediation hypothesis: indirect effects of self-kindness and self-judgement on the relationship between ACEs and CPTSD symptom. Results: ACEs of College students were positively associated with more severe CPTSD symptoms (posttraumatic stress disorder and disturbances in self-organization symptoms). Furthermore, these direct pathways were mediated by decreased self-kindness and increased self-judgement. Conclusions: Findings have substantial theoretical and treatment implications, including the two critical targets (i.e. lowering self-judgement and raising self-kindness) when treating complex PTSD.
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Affiliation(s)
- Tianyou Guo
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
| | - Liuyue Huang
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
| | - Daniel L Hall
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Health Promotion and Resiliency Intervention Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Can Jiao
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Qian Yu
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Xinli Chi
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
| | - Liye Zou
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
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Mohd ZN, Norman S, Gray B, Abdelmasih S, Shetty P, Danson E, Nguyendang T, Yeung A, Lee A. Safety and Efficacy of the Ultrathin Orsiro Sirolimus-Eluting Stent Use in ST Elevation Myocardial Infarct. An Analysis from a Large Australian Regional Centre. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chen ST, Guo T, Yu Q, Stubbs B, Clark C, Zhang Z, Zhu M, Hossain MM, Yeung A, Griffiths MD, Zou L. Active school travel is associated with fewer suicide attempts among adolescents from low-and middle-income countries. Int J Clin Health Psychol 2020; 21:100202. [PMID: 33363585 PMCID: PMC7753036 DOI: 10.1016/j.ijchp.2020.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/02/2020] [Indexed: 11/20/2022] Open
Abstract
Background/Objective: This study explored the association between active school travel (AST) and suicide attempts among adolescents in low- and middle-income countries (LMICs). Method: We used the data from the Global School-based Health Survey, including 127,097 adolescents aged 13-17 years from 34 LMICs. A self-reported survey was used to collect data on AST and suicide attempts as well as some variables. Multivariable logistic regression was performed to assess the association between AST and suicide attempts. A meta-analysis with random effects was undertaken to identify the difference in the association between AST and suicide attempts. Results: Across all the adolescents, the prevalence of AST was 37% and the prevalence of suicide attempts was 11.60%. Adolescents who engaged in AST were less likely to have suicide attempts irrespective of gender. The country-wise analysis indicated a large inconsistency in the association between AST and suicide attempt across the countries. Conclusions: AST would appear to be a protective factor for reducing suicide attempts among adolescents. However, the association between AST and suicide attempts varied greatly across the countries. Future studies should confirm the association between AST and suicide attempts.
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Affiliation(s)
- Si-Tong Chen
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
- Institute for Sport and Health, Victoria University, Melbourne, Australia
| | - Tianyou Guo
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Qian Yu
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
| | - Cain Clark
- Centre for Intelligent Healthcare, Coventry University, United Kingdom
| | - Zhihao Zhang
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Mingyue Zhu
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Md Mahhub Hossain
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, USA
| | - Albert Yeung
- Centre for Intelligent Healthcare, Coventry University, United Kingdom
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | | | - Liye Zou
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
- Corresponding author at: Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, 518060 China.
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Lu C, Chi X, Liang K, Chen ST, Huang L, Guo T, Jiao C, Yu Q, Veronese N, Soares FC, Grabovac I, Yeung A, Zou L. Moving More and Sitting Less as Healthy Lifestyle Behaviors are Protective Factors for Insomnia, Depression, and Anxiety Among Adolescents During the COVID-19 Pandemic. Psychol Res Behav Manag 2020; 13:1223-1233. [PMID: 33364864 PMCID: PMC7751784 DOI: 10.2147/prbm.s284103] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 11/25/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE This study aimed to investigate associations of physical activity time (PAT) and sitting time (ST) independently and jointly with insomnia, depressive and anxiety symptoms among Chinese adolescents in the context of COVID-19. METHODS A cross-sectional study including 965 adolescents (mean age = 15.26, SD = 0.46) was conducted in May 2020. PAT, ST and the symptoms of insomnia, depression and anxiety were assessed with the International Physical Activity Questionnaire Short Form, the Youth Self-Rating Insomnia Scales, the 9-item Patient Health Questionnaire and the Generalized Anxiety Disorder scale via an online survey platform. Logistic regression was used to analyze the association between COVID-19-related fear, PAT, ST and combinations of PAT and ST with insomnia, depressive and anxiety symptoms. RESULTS COVID-19-related fear was associated with higher odds of insomnia, depressive and anxiety symptoms. PAT was associated with lower odds of insomnia and depressive symptoms, while ST was associated with higher odds of these three symptoms. After combining PAT and ST, the group with both low PAT and high ST was set as the referent. For insomnia, groups with low ST reported significantly lower odds of symptoms. For depression, groups with high PAT and/or low ST reported lower odds of symptoms. Regarding anxiety, only the group with both high PAT and low ST reported lower odds of symptoms. Generally, group with both high PAT and low ST reported lower odds of the three symptoms than the referent. CONCLUSION COVID-19-related fear was a risk factor for developing insomnia, depressive and anxiety symptoms among Chinese adolescents. Fortunately, moving more and sitting less were good for sleep and mental health in Chinese adolescents during the pandemic. Educators should help adolescents to be more physically active in their daily life in the primary prevention of adolescent insomnia, depression and anxiety.
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Affiliation(s)
- Chunping Lu
- The Greater Bay Area Institute of Educational Research, Shenzhen University, Shenzhen518060, People’s Republic of China
| | - Xinli Chi
- Center for Lifestyle and Mental Health, Shenzhen University, Shenzhen518060, People’s Republic of China
| | - Kaixin Liang
- Center for Lifestyle and Mental Health, Shenzhen University, Shenzhen518060, People’s Republic of China
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Melbourne8001, Australia
| | - Liuyue Huang
- Center for Lifestyle and Mental Health, Shenzhen University, Shenzhen518060, People’s Republic of China
| | - Tianyou Guo
- Center for Lifestyle and Mental Health, Shenzhen University, Shenzhen518060, People’s Republic of China
| | - Can Jiao
- Center for Lifestyle and Mental Health, Shenzhen University, Shenzhen518060, People’s Republic of China
| | - Qian Yu
- Exercise and Mental Health Laboratory, Shenzhen University, Shenzhen518060, People’s Republic of China
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | | | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Wien1090, Austria
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA02114, USA
| | - Liye Zou
- Exercise and Mental Health Laboratory, Shenzhen University, Shenzhen518060, People’s Republic of China
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Lin J, Guo T, Becker B, Yu Q, Chen ST, Brendon S, Hossain MM, Cunha PM, Soares FC, Veronese N, Yu JJ, Grabovac I, Smith L, Yeung A, Zou L, Li H. Depression is Associated with Moderate-Intensity Physical Activity Among College Students During the COVID-19 Pandemic: Differs by Activity Level, Gender and Gender Role. Psychol Res Behav Manag 2020; 13:1123-1134. [PMID: 33299364 PMCID: PMC7720286 DOI: 10.2147/prbm.s277435] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/07/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The novel coronavirus disease (COVID-19) pandemic and associated restrictive measures have implications for depressive symptoms (henceforth depression) of young people and risk may be associated with their reduced physical activity (PA) level. Therefore, we aimed to examine the association between depressive symptoms and PA among college students with different gender and gender role (masculinity traits and femininity traits) during the COVID-19 pandemic. PARTICIPANTS AND METHODS Cross-sectional study included 628 healthy college students from nineteen different locations. The Center for Epidemiological Studies Depression Scales (CES-D), the International Physical Activity Questionnaire - Short Form (IPAQ-SF), and the 50-item Chinese Sex-Role Inventory (CSRI-50) were used to measure depressive symptoms, PA continuous (weekly metabolic equivalent minutes, MET-minutes/week) and categorical indicators (activity level category) and gender role, respectively. The statistical analyses were used in partial correlation analysis, t-test, one-way ANOVA, moderation model tests, and linear regression model tests. RESULTS Total of 34.72% participants had clinically relevant depression (16, CES-D scale). Total of 58.6% participants were classified as a "low" activity level for spending less time on PA. Depression significantly negatively correlated with MET-minutes/week in moderate-intensity PA but not vigorous and walking scores. Of note, the depression-PA association was only moderated by the "low" activity level group in terms of categorical scores across gender groups. Participants with higher masculinity traits were less likely to have depression among all participants. Moreover, more recovered cases and fewer deaths could also predict the lower depression risk in the "high" activity level group. CONCLUSION Moderate-intensity PA is beneficial for reducing depression risk among college students at a low activity level. College students with fewer masculinity traits (regardless of gender) are highly vulnerable to depression during the outbreak of COVID-19. Effective control of the COVID-19 pandemic seems critical to alleviating the burden of mental disorders of the public including depression.
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Affiliation(s)
- Jingyuan Lin
- Research Centre of Brain Function and Psychological Science; Center for Language and Brain, Shenzhen Institute of Neuroscience; Shenzhen Key Laboratory of Affective and Social Cognitive Science, School of Psychology, Shenzhen University, Shenzhen, 518060, People’s Republic of China
| | - Tianyou Guo
- Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen518060, People’s Republic of China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu610054, Sichuan, People’s Republic of China
| | - Qian Yu
- Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen518060, People’s Republic of China
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Melbourne, VIC, 8001, Australia
| | - Stubbs Brendon
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Md Mahbub Hossain
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX77843, USA
| | - Paolo M Cunha
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Paraná86010-580, Brazil
| | | | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo90100, Italy
| | - Jane Jie Yu
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, New Territories999077, Hong Kong
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Wien, Austria
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, CambridgeCB1 1PT, UK
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA02114, USA
| | - Liye Zou
- Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen518060, People’s Republic of China
| | - Hong Li
- Research Centre of Brain Function and Psychological Science; Center for Language and Brain, Shenzhen Institute of Neuroscience; Shenzhen Key Laboratory of Affective and Social Cognitive Science, School of Psychology, Shenzhen University, Shenzhen, 518060, People’s Republic of China
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Dichtel LE, Carpenter LL, Nyer M, Mischoulon D, Kimball A, Deckersbach T, Dougherty DD, Schoenfeld DA, Fisher L, Cusin C, Dording C, Trinh NH, Pedrelli P, Yeung A, Farabaugh A, Papakostas GI, Chang T, Shapero BG, Chen J, Cassano P, Hahn EM, Rao EM, Brady RO, Singh RJ, Tyrka AR, Price LH, Fava M, Miller KK. Low-Dose Testosterone Augmentation for Antidepressant-Resistant Major Depressive Disorder in Women: An 8-Week Randomized Placebo-Controlled Study. Am J Psychiatry 2020; 177:965-973. [PMID: 32660299 PMCID: PMC7748292 DOI: 10.1176/appi.ajp.2020.19080844] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 12/28/2022]
Abstract
OBJECTIVE Low-dose testosterone has been shown to improve depression symptom severity, fatigue, and sexual function in small studies in women not formally diagnosed with major depressive disorder. The authors sought to determine whether adjunctive low-dose transdermal testosterone improves depression symptom severity, fatigue, and sexual function in women with antidepressant-resistant major depression. A functional MRI (fMRI) substudy examined effects on activity in the anterior cingulate cortex (ACC), a brain region important in mood regulation. METHODS The authors conducted an 8-week randomized double-blind placebo-controlled trial of adjunctive testosterone cream in 101 women, ages 21-70, with antidepressant-resistant major depression. The primary outcome measure was depression symptom severity as assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS). Secondary endpoints included fatigue, sexual function, and safety measures. The primary outcome of the fMRI substudy (N=20) was change in ACC activity. RESULTS The participants' mean age was 47 years (SD=14) and their mean baseline MADRS score was 26.6 (SD=5.9). Eighty-seven (86%) participants completed 8 weeks of treatment. MADRS scores decreased in both study arms from baseline to week 8 (testosterone arm: from 26.8 [SD=6.3] to 15.3 [SD=9.6]; placebo arm: from 26.3 [SD=5.4] to 14.4 [SD=9.3]), with no significant difference between groups. Improvement in fatigue and sexual function did not differ between groups, nor did side effects. fMRI results showed a relationship between ACC activation and androgen levels before treatment but no difference in ACC activation with testosterone compared with placebo. CONCLUSIONS Adjunctive transdermal testosterone, although well tolerated, was not more effective than placebo in improving symptoms of depression, fatigue, or sexual dysfunction. Imaging in a subset of participants demonstrated that testosterone did not result in greater activation of the ACC.
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Affiliation(s)
- Laura E. Dichtel
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Linda L. Carpenter
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Maren Nyer
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - David Mischoulon
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Allison Kimball
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Thilo Deckersbach
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Darin D. Dougherty
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - David A. Schoenfeld
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Lauren Fisher
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Cristina Cusin
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Christina Dording
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Nhi-Ha Trinh
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Paola Pedrelli
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Albert Yeung
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Amy Farabaugh
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - George I. Papakostas
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Trina Chang
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Benjamin G. Shapero
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Justin Chen
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Paolo Cassano
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Emily M. Hahn
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Elizabeth M. Rao
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Roscoe O. Brady
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Ravinder J. Singh
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Audrey R. Tyrka
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Lawrence H. Price
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Maurizio Fava
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
| | - Karen K. Miller
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Dichtel, Kimball, Miller); Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nyer, Mischoulon, Deckersbach, Dougherty, Yeung, Cassano, Hahn, Farabaugh, Pedrelli, Trinh, Dording, Cusin, Papakostas, Chang, Fisher, Shapero, Chen, Fava); Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard
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Feng F, Tuchman S, Denninger JW, Fricchione GL, Yeung A. Qigong for the Prevention, Treatment, and Rehabilitation of COVID-19 Infection in Older Adults. Am J Geriatr Psychiatry 2020; 28:812-819. [PMID: 32425471 PMCID: PMC7227578 DOI: 10.1016/j.jagp.2020.05.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/06/2020] [Accepted: 05/10/2020] [Indexed: 01/25/2023]
Abstract
The elderly are at high risk of contracting respiratory infectious diseases, including COVID-19 infection. The recent pandemic has the potential to cause significant physical and mental damage in older adults. Similarly to other mind-body exercises in Traditional Chinese medicine, Qigong features regulation of breath rhythm and pattern, body movement and posture, and meditation. Given these traits, Qigong has the potential to play a role in the prevention, treatment, and rehabilitation of respiratory infections, such as COVID-19. Potential mechanisms of action include stress reduction, emotion regulation, strengthening of respiratory muscles, reduction of inflammation, and enhanced immune function. Three forms of Qigong; abdominal breathing, Ba Duan Jin and Liu Zi Jue, all of which are gentle, smooth, and simple for the elderly to practice, are recommended in this context.
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Affiliation(s)
- Fan Feng
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
| | - Sylvie Tuchman
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA
| | - John W. Denninger
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
| | - Gregory L. Fricchione
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
| | - Albert Yeung
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA; Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA.
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Ng SM, Lo HHM, Yeung A, Young D, Fung MHY, Wang AM. Study Protocol of Brief Daily Body-Mind-Spirit Practice for Sustainable Emotional Capacity and Work Engagement for Community Mental Health Workers: A Multi-Site Randomized Controlled Trial. Front Psychol 2020; 11:1482. [PMID: 32670170 PMCID: PMC7332841 DOI: 10.3389/fpsyg.2020.01482] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/03/2020] [Indexed: 01/14/2023] Open
Abstract
Background Given the emotional demanding nature of social services, we developed a brief daily body-mind-spirit (BMS) program and successfully piloted it with workers at elderly services. The proposed study focuses on community mental health workers who are often under chronic stress and vulnerable to burnout. Methods The study aims to evaluate the program for fostering sustainable emotional capacity and work engagement for community mental health workers. A multi-site randomized controlled trial design is adopted. All the 24 the Integrated Community Centre for Mental Wellness (ICCMW of Hong Kong will be approached to join this program. Assuming conservatively, 60% ICCWM (14 centers) will respond and participate. At each site, a pair of intervention and control groups will be run. The targeted total sample size is 224. To investigate the course of changes in burnout and engagement, each group will last 6 months, including 3-month intervention and 3-month follow-up. Measures will be taken at monthly intervals. Discussion In light of literature and the pilot trial’s findings, participants in the Brief Daily BMS intervention group are expected to have a reduced burnout level and a narrowing of range in work engagement during the 3 months intervention. And within the 3 months post-intervention period, a rebound of burnout level and a widening of range in work engagement are expected to be observed in the same group of participants. Hopefully, this study will contribute to the deeper understanding of burnout and work engagement, and shed light on sustainable intervention for emotionally demanding workplaces. Clinical Trial Registration The trial has been registered in the Clinical Trials Centre of the University of Hong Kong. HKUCTR-2763 Registered 27 December 2019 – Retrospectively registered, http://www.hkuctr.com/Study/Show/eb930d24e2c647afb7a922055163f24b.
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Affiliation(s)
- S M Ng
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Herman H M Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Albert Yeung
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Daniel Young
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Melody H Y Fung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Amenda M Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
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Oh B, Bae K, Lamoury G, Eade T, Boyle F, Corless B, Clarke S, Yeung A, Rosenthal D, Schapira L, Back M. The Effects of Tai Chi and Qigong on Immune Responses: A Systematic Review and Meta-Analysis. Medicines (Basel) 2020; 7:E39. [PMID: 32629903 PMCID: PMC7400467 DOI: 10.3390/medicines7070039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 06/27/2020] [Accepted: 06/28/2020] [Indexed: 12/13/2022]
Abstract
Background: Effective preventative health interventions are essential to maintain well-being among healthcare professionals and the public, especially during times of health crises. Several studies have suggested that Tai Chi and Qigong (TQ) have positive impacts on the immune system and its response to inflammation. The aim of this review is to evaluate the current evidence of the effects of TQ on these parameters. Methods: Electronic searches were conducted on databases (Medline, PubMed, Embase and ScienceDirect). Searches were performed using the following keywords: "Tai Chi or Qigong" and "immune system, immune function, immunity, Immun*, inflammation and cytokines". Studies published as full-text randomized controlled trials (RCTs) in English were included. Estimates of change in the levels of immune cells and inflammatory biomarkers were pooled using a random-effects meta-analysis where randomised comparisons were available for TQ versus active controls and TQ versus non-active controls. Results: Nineteen RCTs were selected for review with a total of 1686 participants and a range of 32 to 252 participants within the studies. Overall, a random-effects meta-analysis found that, compared with control conditions, TQ has a significant small effect of increasing the levels of immune cells (SMD, 0.28; 95% CI, 0.13 to 0.43, p = 0.00), I2 = 45%, but not a significant effect on reducing the levels of inflammation (SMD, -0.15; 95% CI, -0.39 to 0.09, p = 0.21), I2 = 85%, as measured by the systemic inflammation biomarker C-reactive protein (CRP) and cell mediated biomarker cytokines. This difference in results is due to the bidirectional regulation of cytokines. An overall risk of bias assessment found three RCTs with a low risk of bias, six RCTs with some concerns of bias, and ten RCTs with a high risk of bias. Conclusions: Current evidence indicates that practising TQ has a physiologic impact on immune system functioning and inflammatory responses. Rigorous studies are needed to guide clinical guidelines and harness the power of TQ to promote health and wellbeing.
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Affiliation(s)
- Byeongsang Oh
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Kyeore Bae
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- Center for Immunity and Pain, Kwanghye Hospital, Seoul 06174, Korea
| | - Gillian Lamoury
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Thomas Eade
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Frances Boyle
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Brian Corless
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
| | - Stephen Clarke
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Albert Yeung
- Harvard Medical School, Boston, MA 02115, USA; (A.Y.); (D.R.)
| | - David Rosenthal
- Harvard Medical School, Boston, MA 02115, USA; (A.Y.); (D.R.)
| | - Lidia Schapira
- Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Michael Back
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
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Xu A, Zimmerman CS, Lazar SW, Ma Y, Kerr CE, Yeung A. Distinct Insular Functional Connectivity Changes Related to Mood and Fatigue Improvements in Major Depressive Disorder Following Tai Chi Training: A Pilot Study. Front Integr Neurosci 2020; 14:25. [PMID: 32581734 PMCID: PMC7295154 DOI: 10.3389/fnint.2020.00025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 04/15/2020] [Indexed: 11/29/2022] Open
Abstract
Objective: Tai chi (TC), a contemplative practice combining slow movements and deep breathing, has been shown to be clinically effective in alleviating depressive symptoms. Feelings of fatigue or low vitality often accompany major depressive disorder (MDD) though they are commonly overlooked and not well understood neurologically. By using resting state functional connectivity (rs-FC) using the insula as the seed, this study examines the relationship between mood and vitality symptoms in MDD and how they are impacted by TC training. Methods: Patients (N = 16) with MDD participated in a 10-week TC intervention. Self-report scores of vitality (using the SF-36 scale) and depressed mood (using the Beck Depression Inventory) as well as rs-fMRI were collected pre- and post-intervention. A seed-to-voxel approach was used to test whether changes in insular rs-FC were related to therapeutic improvement in MDD-related symptoms resulting from TC practice. Results: We found decreased self-reported depressed mood and increased vitality following the TC intervention. Furthermore, decreases in depressed mood were associated with increased rs-FC between the right anterior insula (AIC) and superior temporal gyrus and caudate (cluster-corrected p < 0.05). Increased vitality was associated with increased rs-FC between the right posterior insula (PIC) and regions associated with sensorimotor processes (cluster-corrected p < 0.05). Conclusion: These results provide support for differential changes in insula connectivity as neural correlates of symptom improvement in MDD.
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Affiliation(s)
- Anna Xu
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, United States
| | - Chloe S Zimmerman
- Department of Neuroscience, Brown University, Providence, RI, United States.,Alpert Medical School, Brown University, Providence, RI, United States
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Yan Ma
- Harvard Medical School, Boston, MA, United States.,Center for Dynamical Biomarkers, Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Catherine E Kerr
- Alpert Medical School, Brown University, Providence, RI, United States
| | - Albert Yeung
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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Dichtel LE, Carpenter LL, Nyer M, Mischoulon D, Kimball A, Deckersbach T, Dougherty DD, Schoenfeld D, Fisher L, Cusin C, Trinh NH, Pedrelli P, Yeung A, Farabaugh A, Papakostas G, Chang T, Chen J, Cassano P, Rao EM, Brady R, Singh RJ, Tyrka AR, Price L, Fava M, Miller KK. SAT-737 Low-Dose Testosterone Augmentation for Treatment-Resistant Depression in Women: An 8-Week, Two-Site, Randomized, Placebo-Controlled Study. J Endocr Soc 2020. [PMCID: PMC7207466 DOI: 10.1210/jendso/bvaa046.081] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: Nonresponse to selective serotonin reuptake inhibitor and serotonin norepinephrine reuptake inhibitor treatment is common in patients with major depressive disorder (MDD), particularly in women, occurring in about 70% of patients despite adequate dosing. Well-tolerated augmentation strategies are needed, particularly ones that do not cause or exacerbate symptoms such as fatigue and sexual dysfunction. Low-dose testosterone has been shown to improve depression symptom severity, fatigue and sexual function in small studies of women not formally diagnosed with MDD. We sought to determine whether adjunctive low-dose transdermal testosterone improves depression symptom severity, fatigue, and sexual function in women with treatment-resistant MDD. A functional MRI (fMRI) substudy examined effects of testosterone on activity in the anterior cingulate cortex (ACC), a brain region important in mood regulation. Methods: Randomized, double-blind, placebo-controlled, 8-week trial of adjunctive testosterone cream (AndroFeme® 1, Lawley Pharmaceuticals, Australia) in 101 women, ages 21–70, with treatment-resistant MDD. Testosterone was titrated to achieve blood levels near the upper normal reference limit. Primary outcome measure was depression severity by Montgomery-Asberg Depression Rating Scale (MADRS). Secondary endpoints included fatigue, sexual function, and safety measures. fMRI substudy (n=20) primary outcome was change in ACC activity. Results: Mean age was 47±14 (SD) years and mean baseline MADRS score was 26.6±5.9. Eighty-seven (86%) participants completed 8 weeks of treatment. MADRS depression scores decreased in both arms [testosterone: 26.8±6.3 to 15.3±9.6; placebo: 26.3±5.4 to 14.4±9.3 (baseline to 8 weeks, respectively)], with no difference between groups (p=0.91). Fatigue and sexual function improved without differences between groups. There were no group differences in side effects. fMRI results demonstrated a relationship between ACC activation and androgen levels pretreatment but no difference in ACC activation with treatment. Conclusions: This rigorously designed, double-blinded clinical trial did not find significant group differences between adjunctive low dose transdermal testosterone and placebo for antidepressant augmentation in women with treatment-resistant MDD and had a high placebo response rate. Low-dose testosterone was well tolerated but failed to differentially impact overall depressive symptom severity, fatigue, or sexual dysfunction. Testosterone did not result in greater activity in a brain region (ACC) implicated in MDD etiopathology compared to placebo. Thus, the addition of low-dose testosterone to ineffective antidepressant treatment should not be recommended for women with MDD. Further studies using strategies designed to reduce placebo effects may be warranted.
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Affiliation(s)
- Laura E Dichtel
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Linda L Carpenter
- Butler Hospital, Warren Alpert School of Medicine, Providence, RI, USA
| | - Maren Nyer
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Allison Kimball
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David Schoenfeld
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Lauren Fisher
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Cristina Cusin
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Nhi-Ha Trinh
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Paola Pedrelli
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Albert Yeung
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Amy Farabaugh
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - George Papakostas
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Trina Chang
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Justin Chen
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Paolo Cassano
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth M Rao
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Roscoe Brady
- Department of Psychiatry, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA
| | | | - Audrey R Tyrka
- Butler Hospital, Warren Alpert School of Medicine, Providence, RI, USA
| | - Lawrence Price
- Butler Hospital, Warren Alpert School of Medicine, Providence, RI, USA
| | - Maurizio Fava
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Karen Klahr Miller
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Abstract
Congenital infections refer to a group of perinatal infections that may have similar clinical presentations, including rash and ocular findings. TORCH is the acronym that covers these infections (toxoplasmosis, other [syphilis], rubella, cytomegalovirus, herpes simplex virus). There are, however, other important causes of intrauterine/perinatal infections, including enteroviruses, varicella zoster virus, Zika virus, and parvovirus B19. Intrauterine and perinatal infections are significant causes of fetal and neonatal mortality and important contributors to childhood morbidity. A high index of suspicion for congenital infections and awareness of the prominent features of the most common congenital infections can help to facilitate early diagnosis, tailor appropriate diagnostic evaluation, and if appropriate, initiate early treatments. In the absence of maternal laboratory results diagnostic of intrauterine infections, congenital infections should be suspected in newborns with certain clinical features or combinations of clinical features, including hydrops fetalis, microcephaly, seizures, cataract, hearing loss, congenital heart disease, hepatosplenomegaly, jaundice, or rash. Primary prevention of maternal infections during pregnancy is the cornerstone of prevention of congenital infection. Available resources should focus on the promotion of public health.
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Affiliation(s)
- K K Y Leung
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Kowloon Bay, Hong Kong
| | - K L Hon
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Kowloon Bay, Hong Kong
| | - A Yeung
- Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - A K C Leung
- Department of Pediatrics, University of Calgary and Alberta Children's Hospital, Calgary, Canada
| | - E Man
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Kowloon Bay, Hong Kong
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Eddie D, Bentley KH, Bernard R, Yeung A, Nyer M, Pedrelli P, Mischoulon D, Winkelman JW. Major depressive disorder and insomnia: Exploring a hypothesis of a common neurological basis using waking and sleep-derived heart rate variability. J Psychiatr Res 2020; 123:89-94. [PMID: 32044591 PMCID: PMC7047553 DOI: 10.1016/j.jpsychires.2020.01.015] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 01/03/2020] [Accepted: 01/25/2020] [Indexed: 01/16/2023]
Abstract
It remains unclear whether neurobiological dysfunction observed in major depressive disorder (MDD) and insomnia is an expression of common or independent bases. The present investigation sought to explore differences in heart rate variability (HRV)-a widely utilized biomarker of neurobiological functioning-among individuals with MDD, insomnia, and healthy controls, while awake and during distinct sleep stages (REM, N2), with the goal of improving our understanding of shared neurobiological factors in depression and insomnia. Participants were 73 adults who underwent home polysomnography. All N2 and REM sleep epochs with a duration greater than or equal to 5 min were identified for HRV analysis. Additionally, a single waking epoch was defined for each participant. From waking to N2 sleep, and waking to REM sleep, changes in HRV indices indicated participants experienced reductions in sympathetic arousal and increases in parasympathetic arousal. Contrary to hypotheses, however, no between group differences were observed in HRV. Though the present findings do not support the hypotheses of a shard neurobiological pathway between MDD and insomnia, more work is warranted to advance our understanding of the neurobiological bases of these common, debilitating, and frequently co-occurring psychiatric conditions, to improve early detection and identify novel intervention targets for these disorders.
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Affiliation(s)
- David Eddie
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA.
| | - Kate H Bentley
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA
| | - Richard Bernard
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA
| | - Albert Yeung
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA
| | - Maren Nyer
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA
| | - Paola Pedrelli
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA
| | - David Mischoulon
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA
| | - John W Winkelman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA
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Howard C, Saraswat D, McLeod G, Yeung A, Jeong D, Lam J. Canada's Prosthetic Coverage: a Review of Provincial Prosthetic Policy. Can Prosthet Orthot J 2020; 2:33489. [PMID: 37614768 PMCID: PMC10443461 DOI: 10.33137/cpoj.v2i2.33489] [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] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/12/2020] [Indexed: 11/23/2022] Open
Abstract
The Canadian healthcare system serves as an example of equity and federal service to citizens across the world. However, it is not without its challenges. Prosthetic coverage across Canada is highly variable and largely unable to provide equal coverage for Canadian persons living with amputation. Many persons with limb loss are forced to rely upon personal resources, fundraising, or the charity of non-governmental organizations in order to meet this basic healthcare need. This disparity in the Canadian healthcare system is unusual and largely undescribed in the literature. We thus explore the nature of Canadian healthcare prosthetic coverage across Canada, investigating the variability in coverage, presence of prosthetic coverage policies, clarity of policy, eligibility criteria, and interval of prosthetic replacement. Our findings highlight potential areas for improvement within current Canadian healthcare policy.
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Affiliation(s)
- C.W. Howard
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - D.K. Saraswat
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - G McLeod
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - A Yeung
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - D Jeong
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - J Lam
- Faculty of Medicine, McGill University, Montreal, Québec, Canada
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Trinh NH, Tuchman S, Chen J, Chang T, Yeung A. Cultural Humility and the Practice of Consultation-Liaison Psychiatry. Psychosomatics 2020; 61:313-320. [PMID: 32299622 DOI: 10.1016/j.psym.2020.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/28/2020] [Accepted: 03/01/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cultural competency has long been the gold standard for clinicians who treat patients of different races and/or cultural backgrounds than their own. However, in recent years, there has been increasing criticism of the cultural competency framework because of its reliance on stereotypes and an overemphasis on knowledge acquisition. OBJECTIVE We review this transition, including the critiques of cultural competency. We highlight trends in psychiatrist diversity, education, and training on cultural humility, including how consultation-liaison psychiatrists can incorporate advances in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, regarding the role of culture in clinical diagnosis, treatment, and management. METHODS We review the transition from cultural competency to cultural humility, including the critiques of cultural competency. We highlight trends in psychiatrist diversity, education, and training on cultural humility. RESULTS We illustrate how consultation-liaison psychiatrists can incorporate advances in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, regarding the role of culture in clinical diagnosis, treatment, and management. CONCLUSIONS Cultural humility, which minimizes the power imbalance between clinicians and patients and emphasizes patient-focused interviewing and care, is a useful approach for consultation-liaison psychiatrists working with diverse patients and with diverse multidisciplinary teams in the general hospital.
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Affiliation(s)
- Nhi-Ha Trinh
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA; Psychiatry, Harvard Medical School, Boston, MA.
| | - Sylvie Tuchman
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA
| | - Justin Chen
- Psychiatry, Harvard Medical School, Boston, MA; Ambulatory Psychiatry Services, Massachusetts General Hospital, Boston, MA
| | - Trina Chang
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA; Psychiatry, Harvard Medical School, Boston, MA
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43
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Barako T, Li C, Yeung A. Massachusetts General Hospital and the Shanghai Mental Health Center: the past, present and future of a psychiatric research partnership. Gen Psychiatr 2020; 32:e100157. [PMID: 31922093 PMCID: PMC6937152 DOI: 10.1136/gpsych-2019-100157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/04/2019] [Revised: 10/18/2019] [Accepted: 10/23/2019] [Indexed: 11/04/2022] Open
Affiliation(s)
- Tristan Barako
- Development, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Albert Yeung
- Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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44
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Lu C, Zou L, Becker B, D. Griffiths M, Yu Q, Chen ST, Demetrovics Z, Jiao C, Chi X, Chen A, Yeung A, Liu S, Zhang Y. Comparative Effectiveness of Mind-Body Exercise Versus Cognitive Behavioral Therapy for College Students with Problematic Smartphone Use: A Randomized Controlled Trial. International Journal of Mental Health Promotion 2020. [DOI: 10.32604/ijmhp.2020.014419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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45
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Chi X, Becker B, Yu Q, Willeit P, Jiao C, Huang L, Hossain MM, Grabovac I, Yeung A, Lin J, Veronese N, Wang J, Zhou X, Doig SR, Liu X, Carvalho AF, Yang L, Xiao T, Zou L, Fusar-Poli P, Solmi M. Prevalence and Psychosocial Correlates of Mental Health Outcomes Among Chinese College Students During the Coronavirus Disease (COVID-19) Pandemic. Front Psychiatry 2020; 11:803. [PMID: 32848958 PMCID: PMC7427603 DOI: 10.3389/fpsyt.2020.00803] [Citation(s) in RCA: 159] [Impact Index Per Article: 39.8] [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: 05/11/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To investigate the prevalence and risk factors for poor mental health of Chinese university students during the Corona Virus Disease 2019 (COVID-19) pandemic. METHOD Chinese nation-wide on-line cross-sectional survey on university students, collected between February 12th and 17th, 2020. Primary outcome was prevalence of clinically-relevant posttraumatic stress disorder symptoms. Secondary outcomes on poor mental health included prevalence of clinically-relevant anxiety and depressive symptoms, while posttraumatic growth was considered as indicator of effective coping reaction. RESULTS Of 2,500 invited Chinese university students, 2,038 completed the survey. Prevalence of clinically-relevant PTSD, anxiety, and depressive symptoms, and post traumatic growth (PTG) was 30.8, 15.5, 23.3, and 66.9% respectively. Older age, knowing people who had been isolated, more ACEs, higher level of anxious attachment, and lower level of resilience all predicted primary outcome (all p < 0.01). CONCLUSIONS A significant proportion of young adults exhibit clinically relevant posttraumatic stress disorder (PTSD), anxious or depressive symptoms, but a larger portion of individuals showed to effectively cope with COVID-19 pandemic. Interventions promoting resilience should be provided, even remotely, to those subjects with specific risk factors to develop poor mental health during COVID-19 or other pandemics with social isolation.
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Affiliation(s)
- Xinli Chi
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Benjamin Becker
- University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Yu
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | | | - Can Jiao
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Liuyue Huang
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | | | | | - Albert Yeung
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Jingyuan Lin
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Nicola Veronese
- Primary Care Department, Azienda ULSS 3 (Unità Locale Socio Sanitaria) "Serenissima", Dolo-Mirano District, Venice, Italy
| | - Jian Wang
- Anhui Jianzhu University, Hefei, China
| | - Xinqi Zhou
- University of Electronic Science and Technology of China, Chengdu, China
| | - Scott R Doig
- Arkansas State University, Jonesboro, AR, United States
| | - Xiaofeng Liu
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Andre F Carvalho
- Department of Psychiatry, University of Toronto and Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Lin Yang
- Alberta Health Services, Calgary, AB, Canada.,University of Calgary, Calgary, AB, Canada
| | - Tao Xiao
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Liye Zou
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Paolo Fusar-Poli
- Early Psychosis: Intervention and Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Marco Solmi
- Early Psychosis: Intervention and Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, London, United Kingdom.,Neuroscience Center, University of Padua, Padua, Italy
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46
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Mohd Zaki N, Norman S, Krishnamoorthy R, Shetty P, Lee A, Nguyendang T, Yeung A, Danson E. 878 Safety and Efficacy of the Ultrathin Orsio Sirolimus-Eluting Stent use in ST-Elevation Myocardial Infarct. An Analysis From a Large Australian Regional Centre. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.885] [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: 11/25/2022]
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47
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Pedrelli P, Fedor S, Ghandeharioun A, Howe E, Ionescu DF, Bhathena D, Fisher LB, Cusin C, Nyer M, Yeung A, Sangermano L, Mischoulon D, Alpert JE, Picard RW. Monitoring Changes in Depression Severity Using Wearable and Mobile Sensors. Front Psychiatry 2020; 11:584711. [PMID: 33391050 PMCID: PMC7775362 DOI: 10.3389/fpsyt.2020.584711] [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: 07/17/2020] [Accepted: 11/13/2020] [Indexed: 12/14/2022] Open
Abstract
Background: While preliminary evidence suggests that sensors may be employed to detect presence of low mood it is still unclear whether they can be leveraged for measuring depression symptom severity. This study evaluates the feasibility and performance of assessing depressive symptom severity by using behavioral and physiological features obtained from wristband and smartphone sensors. Method: Participants were thirty-one individuals with Major Depressive Disorder (MDD). The protocol included 8 weeks of behavioral and physiological monitoring through smartphone and wristband sensors and six in-person clinical interviews during which depression was assessed with the 17-item Hamilton Depression Rating Scale (HDRS-17). Results: Participants wore the right and left wrist sensors 92 and 94% of the time respectively. Three machine-learning models estimating depressive symptom severity were developed-one combining features from smartphone and wearable sensors, one including only features from the smartphones, and one including features from wrist sensors-and evaluated in two different scenarios. Correlations between the models' estimate of HDRS scores and clinician-rated HDRS ranged from moderate to high (0.46 [CI: 0.42, 0.74] to 0.7 [CI: 0.66, 0.74]) and had moderate accuracy with Mean Absolute Error ranging between 3.88 ± 0.18 and 4.74 ± 1.24. The time-split scenario of the model including only features from the smartphones performed the best. The ten most predictive features in the model combining physiological and mobile features were related to mobile phone engagement, activity level, skin conductance, and heart rate variability. Conclusion: Monitoring of MDD patients through smartphones and wrist sensors following a clinician-rated HDRS assessment is feasible and may provide an estimate of changes in depressive symptom severity. Future studies should further examine the best features to estimate depressive symptoms and strategies to further enhance accuracy.
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Affiliation(s)
- Paola Pedrelli
- The Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States
| | - Szymon Fedor
- The Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Asma Ghandeharioun
- The Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Esther Howe
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Dawn F Ionescu
- Janssen Research and Development, San Diego, CA, United States
| | - Darian Bhathena
- The Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Lauren B Fisher
- The Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States
| | - Cristina Cusin
- The Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States
| | - Maren Nyer
- The Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States
| | - Albert Yeung
- The Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States
| | - Lisa Sangermano
- The Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States
| | - David Mischoulon
- The Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States
| | - Johnathan E Alpert
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, United States
| | - Rosalind W Picard
- The Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
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48
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Lee CF, Zhou K, Young WM, Wong CS, Ng TY, Lee SF, Leung K, Wong LKM, So KH, Tang W, Chong G, Chan SK, Yip YTE, Ma VYM, Yeung A, Chin CHY, Kwan MW, Tsang HT. Febrile neutropenia and its associated hospitalization in breast cancer patients on docetaxel-containing regimen: A retrospective cohort study on duration of prophylactic GCSF administration. Support Care Cancer 2019; 28:3801-3812. [PMID: 31832822 DOI: 10.1007/s00520-019-05111-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 09/30/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE To compare febrile neutropenia (FN) incidence and hospitalization among breast cancer patients on docetaxel with no granulocyte colony-stimulating factors (GCSF) primary prophylaxis (PP), 4/5-day PP, or 7-day PP. METHODS We identified 3916 breast cancer patients using docetaxel-cyclophosphamide (TC), doxorubicin-cyclophosphamide then docetaxel (AC-T), fluorouracil-epirubicin-cyclophosphamide then docetaxel (FEC-T), docetaxel-carboplatin-trastuzumab (TJH), or docetaxel-doxorubicin-cyclophosphamide (TAC) from a hospital pharmacy dispensing database in Hong Kong between 2014 and 2016. Patients were offered GCSF within 5 days since administering docetaxel. Outcomes included FN incidence, time to first hospitalization, hospitalization rate, and duration. RESULTS In TC regimen, FN incidence (with odds ratio, OR) of patients with no PP, 4/5-day PP, and 7-day PP was 21.69%, 7.95% (OR 0.31, p < 0.001), and 5.33% (OR 0.20, p < 0.001), respectively. In TJH regimen, FN incidence of patients with no PP, 4/5-day PP, and 7-day PP was 38.26%, 8.33% (OR 0.15, p < 0.001), and 8.57% (OR 0.15, p < 0.001), respectively. FN incidence of patients on AC-T regimen with no PP and 4/5-day PP was 20.93% and 6.84%, respectively (OR 0.28, p = 0.005); with FEC-T regimen, the incidence was 9.91% and 4.77%, respectively (OR 0.46, p = 0.035). Only 3.27% FN cases were not hospitalized. Mean (±standard deviation, SD) time to first hospitalization was 8.21 ± 2.44 days. Mean (±SD) duration of hospitalization for patients with no PP, 4/5-day PP, and 7-day PP was 4.66 ± 2.60, 4.37 ± 2.85, and 5.12 ± 2.97 days, respectively. CONCLUSION GCSF prophylaxis in breast cancer patients on docetaxel could reduce FN incidence and hospitalization. 4/5-day PP demonstrated similar efficacy to 7-day PP with superior saving benefits on healthcare expenditure.
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Affiliation(s)
- C F Lee
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong. .,Department of Pharmacy, Tuen Mun Hospital, Tuen Mun, Hong Kong.
| | - K Zhou
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - W M Young
- Department of Pharmacy, Tuen Mun Hospital, Tuen Mun, Hong Kong.,COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong
| | - C S Wong
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - T Y Ng
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - S F Lee
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - K Leung
- COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.,Department of Pharmacy, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - L K M Wong
- COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.,Department of Pharmacy, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - K H So
- COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.,Department of Pharmacy, Prince of Wales Hospital, Sha Tin, Hong Kong
| | - W Tang
- COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.,Department of Pharmacy, United Christian Hospital, Kwun Tong, Hong Kong
| | - G Chong
- COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.,Department of Pharmacy, United Christian Hospital, Kwun Tong, Hong Kong
| | - S K Chan
- Department of Pharmacy, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - Y T E Yip
- COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.,Department of Pharmacy, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - V Y M Ma
- COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.,Department of Pharmacy, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - A Yeung
- Department of Pharmacy, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - C H Y Chin
- Department of Pharmacy, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - M W Kwan
- Department of Pharmacy, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - H T Tsang
- Department of Pharmacy, Queen Elizabeth Hospital, Kowloon, Hong Kong
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Sakurai H, Dording C, Yeung A, Foster S, Jain F, Chang T, Trinh NH, Bernard R, Boyden S, Iqbal SZ, Wilkinson ST, Mathew SJ, Mischoulon D, Fava M, Cusin C. Longer-term open-label study of adjunctive riluzole in treatment-resistant depression. J Affect Disord 2019; 258:102-108. [PMID: 31400624 PMCID: PMC6710149 DOI: 10.1016/j.jad.2019.06.065] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 05/03/2019] [Accepted: 06/30/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND While riluzole has been investigated for the treatment of depression, little is known about its longer-term efficacy and optimal treatment duration in treatment-resistant depression (TRD). The objective of this study is to characterize the longer-term outcome of adjunctive riluzole therapy for TRD in an open-label extension of an 8-week acute treatment trial. METHODS The data from 66 patients with TRD who received adjunctive riluzole in a 12-week open-label extension phase were analyzed. Response rates (⩾50% reduction in the Mongomery-Asberg Depression Rating Scale [MADRS] score), relapse rates (a MADRS score of ⩾22 in patients who had previously achieved response), and adverse events were examined in patients who had achieved response at the end of the acute phase and those who had not. RESULTS Among acute phase responders, the maintained response rate was 66.7% (8/12) and the relapse rate was 8.3% (1/12). In acute phase non-responders, the response rate was 24.1% (13/54). The most commonly reported adverse event was fatigue (9.1%). Three cases were considered serious adverse events; vomiting (n = 1), shortness of breath (n = 1), and aborted suicide attempt (n = 1). LIMITATIONS This longer-term study was open-label and uncontrolled. The sample size was relatively small. CONCLUSIONS Longer-term adjunctive riluzole appears relatively well tolerated and beneficial for maintaining previous response. Additionally, approximately one fourth of patients who did not respond to 8-week antidepressant treatment might respond if treated with riluzole for 12 weeks. Those findings warrant further investigation because adjunctive riluzole could represent an option for treatment of depression when standard antidepressants have failed.
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Affiliation(s)
- Hitoshi Sakurai
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Christina Dording
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Albert Yeung
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Simmie Foster
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Felipe Jain
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Trina Chang
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Nhi-Ha Trinh
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Richard Bernard
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Sean Boyden
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Syed Z Iqbal
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA,Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Samuel T Wilkinson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sanjay J Mathew
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA,Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Maurizio Fava
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Cristina Cusin
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 6th Floor, Boston, MA, USA.
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50
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Dichtel L, Kimball A, Nyer M, Mischoulon D, Fisher L, Cusin C, Dording C, Trinh NH, Yeung A, Rao E, Pinna G, Carpenter L, Fava M, Miller K. MON-449 Serum Neuroactive Steroid Levels in Postmenopausal Women with Treatment-Resistant Major Depressive Disorder. J Endocr Soc 2019. [PMCID: PMC6550586 DOI: 10.1210/js.2019-mon-449] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Neuroactive steroids such as 3α-5α-tetrahydroprogesterone (allopregnanolone) and 5α-androstane-3α,17β-diol (3α-androstanediol) are modulators of traditional neurotransmitter receptors and have been implicated in the etiopathology of psychiatric disorders, including depression, but levels have not been assessed in women with treatment-resistant major depressive disorder (MDD). We hypothesized that allopregnanolone, 3α-androstanediol, and the ratio of these steroid levels to their precursors (progesterone and testosterone, respectively) would be lower in postmenopausal women with treatment-resistant MDD than non-depressed controls. Methods: Fasting serum neuroactive steroid levels measured by gas chromatography/mass spectrometry were compared in women with treatment-resistant MDD (MDD, n=12) [Montgomery-Asberg Depression Rating Scale (MADRS) >12 despite an adequately dosed antidepressant] and in healthy controls without depression (HC, n=28). All subjects were postmenopausal nonsmokers; none were receiving systemic estrogen. Results: Mean age and BMI did not differ between groups. In MDD, mean number of antidepressants per subject was 1.5±0.5 (SD), with 58% receiving selective serotonin reuptake inhibitors and 50% bupropion. Mean MADRS was 24.4±5.8 (moderate depression severity). In MDD vs HC, the mean allopregnanolone/progesterone ratio was lower (0.20±0.19 vs 0.47±0.46, p=0.03) and progesterone levels were higher (153±177 vs 57±50 pg/mL, p=0.04). There was no difference in mean allopregnanolone levels between groups. Compared with HC, MDD subjects had lower serum free testosterone (0.21±0.16 vs 0.38±0.18 ng/dL, p=0.006) and a trend toward lower total testosterone (13.3±5.9 vs 18.6±9.9 ng/dL, p=0.06). There was no difference in 3α-androstanediol levels or 3α-androstanediol/total testosterone ratio between groups. There was a trend toward a positive association between progesterone levels and depression severity (r=0.34, p=0.06) and an inverse association between the allopregnanolone/progesterone ratio and depression severity (r=-0.36, p=0.07). Lower free testosterone levels were associated with greater depression severity (r=-0.45, p=0.03). Conclusion: In postmenopausal women with treatment-resistant MDD, the allopregnanolone/progesterone ratio was lower and progesterone levels higher than in non-depressed controls. Allopregnanolone levels did not differ between groups. This may be due to reduced metabolism of progesterone to allopregnanolone and could have treatment implications. Additionally, testosterone levels were lower in depressed women, but there was no difference in 3α-androstanediol levels or the 3α-androstanediol/total testosterone ratio between depressed and non-depressed women, suggesting that testosterone may play a greater role in depression symptomatology than its metabolite.
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Affiliation(s)
- Laura Dichtel
- Neuroendocrine Unit, Neuroendocrine Unit, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
| | - Allison Kimball
- Neuroendocrine Unit, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
| | - Maren Nyer
- Depression Clinical and Research Program, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
| | - Lauren Fisher
- Depression Clinical and Research Program, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
| | - Cristina Cusin
- Depression Clinical and Research Program, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
| | - Christina Dording
- Depression Clinical and Research Program, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
| | - Nhi-Ha Trinh
- Depression Clinical and Research Program, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
| | - Elizabeth Rao
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, United States
| | - Graziano Pinna
- The Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Linda Carpenter
- Butler Hospital, Brown Department of Psychiatry and Human Behavior, Providence, RI, United States
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
| | - Karen Miller
- Neuroendocrine Unit, Neuroendocrine Unit, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
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