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Longhitano Y, Racca F, Zanza C, Piccioni A, Audo A, Muncinelli M, Santi R, Kozel D, Geraci C, Taverna M, Bonato V, Cassini F, Franceschi F. Venous thromboembolism in critically ill patients affected by ARDS related to COVID-19 in Northern-West Italy. Eur Rev Med Pharmacol Sci 2020; 24:9154-9160. [PMID: 32965007 DOI: 10.26355/eurrev_202009_22864] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. An association between increased venous thromboembolism in patients with pneumonia-related to COVID-19 has not yet been well described. PATIENTS AND METHODS We aimed to illustrate cases of pulmonary thromboembolism in patients with acute respiratory distress syndrome related to COVID-19 treated in our intensive care unit. The medical records of patients affected by COVID-19 with acute respiratory distress syndrome in our institute from 1/3/2020 to 31/3/2020 were retrospectively reviewed. RESULTS Our center registered a high prevalence of thromboembolic events among 62 patients affected by acute respiratory distress syndrome related to COVID-19 despite a regular antithrombotic prophylaxis. Out of these, 32 patients were transferred to other hospitals, and 30 were treated in our center. Venous thromboembolism was registered in 12 (19.3%) cases. In particular, 11 diagnoses of pulmonary embolism and 1 diagnosis of deep vein thrombosis were formulated. We described a case series of venous thromboembolism in nine patients treated in our Intensive Care Unit (ICU). Main pulmonary arteries were always involved in these patients. None of them died. CONCLUSIONS In conclusion, critically ill patients with ARDS related to COVID-19 may have an increased risk of VTE that could be a leading cause of mortality. These patients require a high index of clinical suspicion and an accurate diagnostic approach, in order to immediately start an appropriate anticoagulant treatment.
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Affiliation(s)
- Y Longhitano
- Department of Anesthesiology and Critical Care, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy.
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Power RA, Keers R, Ng MY, Butler AW, Uher R, Cohen-Woods S, Ising M, Craddock N, Owen MJ, Korszun A, Jones L, Jones I, Gill M, Rice JP, Hauser J, Henigsberg N, Maier W, Zobel A, Mors O, Placentino AS, Rietschel M, Souery D, Kozel D, Preisig M, Lucae S, Binder EB, Aitchison KJ, Tozzi F, Muglia P, Breen G, Craig IW, Farmer AE, Müller-Myhsok B, McGuffin P, Lewis CM. Dissecting the genetic heterogeneity of depression through age at onset. Am J Med Genet B Neuropsychiatr Genet 2012; 159B:859-68. [PMID: 22915352 DOI: 10.1002/ajmg.b.32093] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 07/25/2012] [Indexed: 11/09/2022]
Abstract
Genome-wide studies in major depression have identified few replicated associations, potentially due to heterogeneity within the disorder. Several studies have suggested that age at onset (AAO) can distinguish sub-types of depression with specific heritable components. This paper investigates the role of AAO in the genetic susceptibility for depression using genome-wide association data on 2,746 cases and 1,594 screened controls from the RADIANT studies, with replication performed in 1,471 cases and 1,403 controls from two Munich studies. Three methods were used to analyze AAO: First a time-to-event analysis with controls censored, secondly comparing controls to case-subsets defined using AAO cut-offs, and lastly analyzing AAO as a quantitative trait. In the time-to-event analysis three SNPs reached suggestive significance (P < 5E-06), overlapping with the original case-control analysis of this study. In a case-control analysis using AAO thresholds, SNPs in 10 genomic regions showed suggestive association though again none reached genome-wide significance. Lastly, case-only analysis of AAO as a quantitative trait resulted in 5 SNPs reaching suggestive significance. Sex specific analysis was performed as a secondary analysis, yielding one SNP reaching genome-wide significance in early-onset males. No SNPs achieved significance in the replication study after correction for multiple testing. Analysis of AAO as a quantitative trait did suggest that, across all SNPs, common genetic variants explained a large proportion of the variance (51%, P = 0.04). This study provides the first focussed analysis of the genetic contribution to AAO in depression, and establishes a statistical framework that can be applied to a quantitative trait underlying any disorder.
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Affiliation(s)
- Robert A Power
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom.
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Strohmaier J, Wüst S, Uher R, Henigsberg N, Mors O, Hauser J, Souery D, Zobel A, Dernovsek MZ, Streit F, Schmäl C, Kozel D, Placentino A, Farmer A, Mcguffin P, Aitchison KJ, Rietschel M. Sexual dysfunction during treatment with serotonergic and noradrenergic antidepressants: clinical description and the role of the 5-HTTLPR. World J Biol Psychiatry 2011; 12:528-38. [PMID: 21388237 PMCID: PMC3279131 DOI: 10.3109/15622975.2011.559270] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [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: 12/17/2022]
Abstract
OBJECTIVES Sexual dysfunction (SD) is a frequently reported side-effect of antidepressant treatment, particularly of selective serotonin reuptake inhibitors (SSRIs). In the multicentre clinical and pharmacogenetic GENDEP study (Genome-based Therapeutic Drugs for Depression), the effect of the serotonin transporter gene promoter polymorphism 5-HTTLPR on sexual function was investigated during treatment with escitalopram (SSRI) and nortriptyline (tricyclic antidepressant). METHODS A total of 494 subjects with an episode of DSM-IV major depression were randomly assigned to treatment with escitalopram or nortriptyline. Over 12 weeks, depressive symptoms and SD were measured weekly with the Montgomery-Asberg Depression Rating Scale, the Antidepressant Side-Effect Checklist, the UKU Side Effect Rating Scale, and the Sexual Functioning Questionnaire. RESULTS The incidence of reported SD after 12 weeks of treatment was relatively low, and did not differ significantly between antidepressants (14.9% escitalopram, 19.7% nortriptyline). There was no significant interaction between the 5-HTTLPR and antidepressant on SD. Improvement in depressive symptoms and younger age were both associated with lower SD. The effect of age on SD may have been moderated by the 5-HTTLPR. CONCLUSIONS In GENDEP, rates of reported SD during treatment were lower than those described in previous reports. There was no apparent effect of the 5-HTTLPR on the observed decline in SD.
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Affiliation(s)
- Jana Strohmaier
- Central Institute of Mental Health, Division of Genetic Epidemiology in Psychiatry, Mannheim, Germany.
| | - Stefan Wüst
- Central Institute of Mental Health, Division of Genetic Epidemiology in Psychiatry, Mannheim, Germany
| | - Rudolf Uher
- Medical Research Council (MRC) Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK
| | - Neven Henigsberg
- Croatian Institute for Brain Research, Medical School, University of Zagreb, Croatia
| | - Ole Mors
- Aarhus University Hospital, Risskov, Denmark
| | - Joanna Hauser
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | - Daniel Souery
- Laboratoire de Psychologie Médicate, Université Libre de Bruxelles and Psy Pluriel – Centre Européen de Psychologie Médicale, Belgium
| | - Astrid Zobel
- Department of Psychiatry, University of Bonn, Germany
| | | | - Fabian Streit
- Central Institute of Mental Health, Division of Genetic Epidemiology in Psychiatry, Mannheim, Germany,Institute of Psychobiology, University of Trier, Germany
| | - Christine Schmäl
- Central Institute of Mental Health, Division of Genetic Epidemiology in Psychiatry, Mannheim, Germany
| | - Dejan Kozel
- Institute of Public Health, Ljubljana, Slovenia
| | - Anna Placentino
- Psychiatric Unit 23, Department of Mental Health, Spedali Civili Hospital and Biological Psychiatry Unit, Centro San Giovanni di Dio IRCCS-FBF, Brescia, Italy
| | - Anne Farmer
- Medical Research Council (MRC) Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK
| | - Peter Mcguffin
- Medical Research Council (MRC) Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK
| | - Katherine J Aitchison
- Medical Research Council (MRC) Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK,Division of Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College London, UK
| | - Marcella Rietschel
- Central Institute of Mental Health, Division of Genetic Epidemiology in Psychiatry, Mannheim, Germany
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Keers R, Bonvicini C, Scassellati C, Uher R, Placentino A, Giovannini C, Rietschel M, Henigsberg N, Kozel D, Mors O, Maier W, Hauser J, Souery D, Mendlewicz J, Schmäl C, Zobel A, Larsen ER, Szczepankiewicz A, Kovacic Z, Elkin A, Craig I, McGuffin P, Farmer AE, Aitchison KJ, Gennarelli M. Variation in GNB3 predicts response and adverse reactions to antidepressants. J Psychopharmacol 2011; 25:867-74. [PMID: 20826553 DOI: 10.1177/0269881110376683] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [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: 11/15/2022]
Abstract
There is substantial inter-individual variation in response and adverse reactions to antidepressants, and genetic variation may, in part, explain these differences. GNB3 encodes the β3 subunit of the G protein complex, which is involved in the downstream signalling cascade following monoamine receptor activation. A functional polymorphism in this gene (C825T) has been associated with response to antidepressants. Several lines of evidence suggest that GNB3 moderates improvement in the neurovegetative symptoms of depression (such as sleep and appetite) and related adverse reactions independently of change in core mood symptoms. We here report analysis of data from GENDEP, a part-randomized pharmacogenomic trial, on the outcome of 811 subjects with major depression undergoing treatment with either escitalopram or nortriptyline in which the C825T SNP and three further SNPs in GNB3 were genotyped. The TT genotype was significantly associated with a superior response to nortriptyline and these effects were specific to improvements in neurovegetative symptoms. In addition, the same genotype predicted fewer incidents of treatment-emergent insomnia and greater weight gain on the same drug. Our results are consistent with previous associations with GNB3 and emphasize the importance of signalling genes in antidepressant response.
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Affiliation(s)
- Robert Keers
- MRC SGDP Centre, Institute of Psychiatry, King's College London, UK.
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Meglic M, Furlan M, Kuzmanic M, Kozel D, Baraga D, Kuhar I, Kosir B, Iljaz R, Novak Sarotar B, Dernovsek MZ, Marusic A, Eysenbach G, Brodnik A. Feasibility of an eHealth service to support collaborative depression care: results of a pilot study. J Med Internet Res 2010; 12:e63. [PMID: 21172765 PMCID: PMC3057312 DOI: 10.2196/jmir.1510] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 06/08/2010] [Accepted: 06/09/2010] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Treatments and organizational changes supported by eHealth are beginning to play an important role in improving disease treatment outcome and providing cost-efficient care management. "Improvehealth.eu" is a novel eHealth service to support the treatment of patients with depressive disorder. It offers active patient engagement and collaborative care management by combining Web- and mobile-based information and communication technology systems and access to care managers. OBJECTIVES Our objective was to assess the feasibility of a novel eHealth service. METHODS The intervention--the "Improvehealth.eu" service--was explored in the course of a pilot study comparing two groups of patients receiving treatment as usual and treatment as usual with eHealth intervention. We compared patients' medication adherence and outcome measures between both groups and additionally explored usage and overall perceptions of the intervention in intervention group. RESULTS The intervention was successfully implemented in a pilot with 46 patients, of whom 40 were female. Of the 46 patients, 25 received treatment as usual, and 21 received the intervention in addition to treatment as usual. A total of 55% (12/25) of patients in the former group and 45% (10/21) in the latter group finished the 6-month pilot. Available case analysis indicated an improvement of adherence in the intervention group (odds ratio [OR] = 10.0, P = .03). Intention-to-treat analysis indicated an improvement of outcome in the intervention group (ORs ranging from 0.35 to 18; P values ranging from .003 to .20), but confidence intervals were large due to small sample sizes. Average duration of use of the intervention was 107 days. The intervention was well received by 81% (17/21) of patients who reported feeling actively engaged, in control of their disease, and that they had access to a high level of information. In all, 33% (7/21) of the patients also described drawbacks of the intervention, mostly related to usability issues. CONCLUSIONS The results of this pilot study indicate that the intervention was well accepted and helped the patients in the course of treatment. The results also suggest the potential of the intervention to improve both medication adherence and outcome measures of treatment, including reduction of depression severity and patients becoming "healthy."
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Affiliation(s)
- Matic Meglic
- Primorska Institute of Nature Science and Technology, University of Primorska, Koper, Slovenia.
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Keers R, Uher R, Gupta B, Rietschel M, Schulze TG, Hauser J, Skibinska M, Henigsberg N, Kalember P, Maier W, Zobel A, Mors O, Kristensen AS, Kozel D, Giovannini C, Mendlewicz J, Kumar S, McGuffin P, Farmer AE, Aitchison KJ. Stressful life events, cognitive symptoms of depression and response to antidepressants in GENDEP. J Affect Disord 2010; 127:337-42. [PMID: 20609482 DOI: 10.1016/j.jad.2010.06.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 06/02/2010] [Accepted: 06/03/2010] [Indexed: 11/24/2022]
Abstract
BACKGROUND The occurrence of stressful life events (SLEs) has been shown to predict response to antidepressants; however, results are inconsistent. There is some evidence to suggest that SLEs prior to treatment are associated with greater cognitive symptoms at baseline and may therefore predict changes in these symptoms specifically. METHODS GENDEP, a prospective part-randomised pharmacogenomics trial, collected longitudinal data on the symptoms of patients with major depression treated with either a selective serotonin reuptake inhibitor (SSRI, escitalopram) or a tricyclic antidepressant (TCA, nortriptyline). Data on life events experienced in the 6 months preceding treatment measured using the List of Threatening Experiences Questionnaire (LTE-Q) were available for 728 participants. RESULTS Both the occurrence and number of SLEs were associated with greater cognitive but not mood or neurovegetative symptoms prior to treatment. Those who reported SLEs also experienced a greater decline in cognitive symptoms during treatment with escitalopram, but not with nortriptyline. LIMITATIONS Life events were measured retrospectively using a self-report checklist and are therefore subject to a number of biases especially in the context of depressive illness. CONCLUSIONS These findings are in line with cognitive theories of depression and suggest that symptomatic heterogeneity may have contributed to inconsistencies in studies reported to date. Our results also tentatively suggest a clinically relevant drug specific effect of SLEs. Specifically, those reporting stress may benefit more from treatment with SSRIs than TCAs.
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Affiliation(s)
- Robert Keers
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK.
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Maffe S, Dellavesa P, Zenone F, Paino AM, Paffoni P, Perucca A, Kozel D, Signorotti F, Bielli M, Parravicini U, Pardo NF, Cucchi L, Aymele AG, Zanetta M. Transthoracic second harmonic two- and three-dimensional echocardiography for detection of patent foramen ovale. European Journal of Echocardiography 2009; 11:57-63. [DOI: 10.1093/ejechocard/jep165] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Uher R, Mors O, Hauser J, Rietschel M, Maier W, Kozel D, Henigsberg N, Souery D, Placentino A, Perroud N, Dernovsek MZ, Strohmaier J, Larsen ER, Zobel A, Leszczynska-Rodziewicz A, Kalember P, Pedrini L, Linotte S, Gunasinghe C, Aitchison KJ, McGuffin P, Farmer A. Body weight as a predictor of antidepressant efficacy in the GENDEP project. J Affect Disord 2009; 118:147-54. [PMID: 19269691 DOI: 10.1016/j.jad.2009.02.013] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 02/19/2009] [Accepted: 02/19/2009] [Indexed: 11/30/2022]
Abstract
BACKGROUND Being overweight or obese may be associated with poor response to antidepressants. The present report explores the moderation of antidepressant response by body weight to establish the specificity to antidepressant mode of action, type of depressive symptoms and gender. METHODS Height and weight were measured in 797 men and women with major depression treated with escitalopram or nortriptyline for twelve weeks as part of the Genome Based Therapeutic Drugs for Depression (GENDEP) project. Body mass index (BMI) and obesity (BMI>30) were tested as predictors of change in depressive symptoms using mixed linear models. RESULTS Higher BMI and obesity predicted poor response to nortriptyline but did not significantly influence response to escitalopram. The moderation of response by body weight was due to differential improvement in neurovegetative symptoms, including sleep and appetite. The relationship between body weight and change in neurovegetative symptoms was moderated by gender with obese men responding less to nortriptyline and obese women having poorer response to both antidepressants. LIMITATIONS As no placebo arm was included, the specificity of findings to antidepressants is relative. Lack of specific measures precluded accounting for differences in body fat distribution. CONCLUSIONS Body weight should be considered in the assessment of depression as it may inform the selection of antidepressant treatment.
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Affiliation(s)
- Rudolf Uher
- Institute of Psychiatry, King's College London, United Kingdom.
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Uher R, Farmer A, Henigsberg N, Rietschel M, Mors O, Maier W, Kozel D, Hauser J, Souery D, Placentino A, Strohmaier J, Perroud N, Zobel A, Rajewska-Rager A, Dernovsek MZ, Larsen ER, Kalember P, Giovannini C, Barreto M, McGuffin P, Aitchison KJ. Adverse reactions to antidepressants. Br J Psychiatry 2009; 195:202-10. [PMID: 19721108 DOI: 10.1192/bjp.bp.108.061960] [Citation(s) in RCA: 168] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Adverse drug reactions are important determinants of non-adherence to antidepressant treatment, but their assessment is complicated by overlap with depressive symptoms and lack of reliable self-report measures. AIMS To evaluate a simple self-report measure and describe adverse reactions to antidepressants in a large sample. METHOD The newly developed self-report Antidepressant Side-Effect Checklist and the psychiatrist-rated UKU Side Effect Rating Scale were repeatedly administered to 811 adult participants with depression in a part-randomised multicentre open-label study comparing escitalopram and nortriptyline. RESULTS There was good agreement between self-report and psychiatrists' ratings. Most complaints listed as adverse reactions in people with depression were more common when they were medication-free rather than during their treatment with antidepressants. Dry mouth (74%), constipation (33%) and weight gain (15%) were associated with nortriptyline treatment. Diarrhoea (9%), insomnia (36%) and yawning (16%) were more common during treatment with escitalopram. Problems with urination and drowsiness predicted discontinuation of nortriptyline. Diarrhoea and decreased appetite predicted discontinuation of escitalopram. CONCLUSIONS Adverse reactions to antidepressants can be reliably assessed by self-report. Attention to specific adverse reactions may improve adherence to antidepressant treatment.
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Affiliation(s)
- Rudolf Uher
- P080 SGDP, Institute of Psychiatry, King's College London, London SE5 8AF, UK.
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Uher R, Huezo-Diaz P, Perroud N, Smith R, Rietschel M, Mors O, Hauser J, Maier W, Kozel D, Henigsberg N, Barreto M, Placentino A, Dernovsek MZ, Schulze TG, Kalember P, Zobel A, Czerski PM, Larsen ER, Souery D, Giovannini C, Gray JM, Lewis CM, Farmer A, Aitchison KJ, McGuffin P, Craig I. Genetic predictors of response to antidepressants in the GENDEP project. Pharmacogenomics J 2009; 9:225-33. [PMID: 19365399 DOI: 10.1038/tpj.2009.12] [Citation(s) in RCA: 146] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The objective of the Genome-based Therapeutic Drugs for Depression study is to investigate the function of variations in genes encoding key proteins in serotonin, norepinephrine, neurotrophic and glucocorticoid signaling in determining the response to serotonin-reuptake-inhibiting and norepinephrine-reuptake-inhibiting antidepressants. A total of 116 single nucleotide polymorphisms in 10 candidate genes were genotyped in 760 adult patients with moderate-to-severe depression, treated with escitalopram (a serotonin reuptake inhibitor) or nortriptyline (a norepinephrine reuptake inhibitor) for 12 weeks in an open-label part-randomized multicenter study. The effect of genetic variants on change in depressive symptoms was evaluated using mixed linear models. Several variants in a serotonin receptor gene (HTR2A) predicted response to escitalopram with one marker (rs9316233) explaining 1.1% of variance (P=0.0016). Variants in the norepinephrine transporter gene (SLC6A2) predicted response to nortriptyline, and variants in the glucocorticoid receptor gene (NR3C1) predicted response to both antidepressants. Two HTR2A markers remained significant after hypothesis-wide correction for multiple testing. A false discovery rate of 0.106 for the three strongest associations indicated that the multiple findings are unlikely to be false positives. The pattern of associations indicated a degree of specificity with variants in genes encoding proteins in serotonin signaling influencing response to the serotonin-reuptake-inhibiting escitalopram, genes encoding proteins in norepinephrine signaling influencing response to the norepinephrine-reuptake-inhibiting nortriptyline and a common pathway gene influencing response to both antidepressants. The single marker associations explained only a small proportion of variance in response to antidepressants, indicating a need for a multivariate approach to prediction.
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Affiliation(s)
- Rudolf Uher
- MRC Social Genetic and Developmental Psychiatry Center, Institute of Psychiatry, King's College London, London, UK.
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Uher R, Farmer A, Maier W, Rietschel M, Hauser J, Marusic A, Mors O, Elkin A, Williamson RJ, Schmael C, Henigsberg N, Perez J, Mendlewicz J, Janzing JGE, Zobel A, Skibinska M, Kozel D, Stamp AS, Bajs M, Placentino A, Barreto M, McGuffin P, Aitchison KJ. Measuring depression: comparison and integration of three scales in the GENDEP study. Psychol Med 2008; 38:289-300. [PMID: 17922940 DOI: 10.1017/s0033291707001730] [Citation(s) in RCA: 190] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND A number of scales are used to estimate the severity of depression. However, differences between self-report and clinician rating, multi-dimensionality and different weighting of individual symptoms in summed scores may affect the validity of measurement. In this study we examined and integrated the psychometric properties of three commonly used rating scales. METHOD The 17-item Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI) were administered to 660 adult patients with unipolar depression in a multi-centre pharmacogenetic study. Item response theory (IRT) and factor analysis were used to evaluate their psychometric properties and estimate true depression severity, as well as to group items and derive factor scores. RESULTS The MADRS and the BDI provide internally consistent but mutually distinct estimates of depression severity. The HAMD-17 is not internally consistent and contains several items less suitable for out-patients. Factor analyses indicated a dominant depression factor. A model comprising three dimensions, namely 'observed mood and anxiety', 'cognitive' and 'neurovegetative', provided a more detailed description of depression severity. CONCLUSIONS The MADRS and the BDI can be recommended as complementary measures of depression severity. The three factor scores are proposed for external validation.
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Affiliation(s)
- R Uher
- Medical Research Council, Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK.
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Kozel D, Marusić A. Individuals with diabetes mellitus with and without depressive symptoms: could social network explain the comorbidity? Psychiatr Danub 2006; 18:12-8. [PMID: 16804495] [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] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVES The main objective of the present study was to obtain an approximate prevalence of depressive symptoms in a community sample of persons with diabetes mellitus and to discover whether social networks could explain comorbidity of diabetes mellitus and depressive symptoms. METHOD Subjects were persons with diabetes mellitus, members of the Diabetes Association of Ljubljana (N = 396, average age: 62.9 +/- 13.4, average duration of diabetes: 17.2 +/- 10.6). Firstly, subjects were screened with CESD (Centre for Epidemiological Studies Depression Scale) and demographic data were also gathered. Secondly, two samples (individuals with and without depressive symptoms) were compared on the basis of social network analysis. RESULTS The prevalence of depressive symptoms was higher among persons with diabetes in comparison with general population. Individuals with depressive symptoms compared with individuals without depressive symptoms were less dissatisfied with diabetes (p = 0.011), and had better informational (p = 0.039) and instrumental support (p = 0.046), relations between them and support givers were closer (p = 0.050), more important and less conflicting (p = 0.042). Compared groups did not differ in quantitative characteristics of social networks (eg. size of the network or the network gender structure). CONCLUSIONS The community sample results in Slovenia support the already reported association between diabetes mellitus and depression. Furthermore, social network analysis offered some potentially relevant explanation for comorbidity of diabetes mellitus and depressive symptoms.
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Affiliation(s)
- Dejan Kozel
- Institute of Public Health of the Republic of Slovenia, Ljubljana, Slovenia.
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Sarasino D, Kozel D, Marchisio S, Demarchi ML, Palin LA, Panella M. [Epidemiologic study on the performance of a smoking prevention program in an adolescent population]. Ann Ig 2002; 14:263-72. [PMID: 12162124] [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] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
In the last few years, the relative number of adolescent smokers has increased, which indicates the need to boost the adoption of new preventive strategies aimed at this part of the population. In order to be effective, preventive actions should be put in the local setting thoroughly knowing the target population and any specific-predictive factors of the insurgence of smoking addiction. To this purpose, we conducted a study aimed at describing the prevalence of smoking addiction in a population of 2472 adolescents and at identifying any predisposing factors. From the analysis of the results, both predisposing and protective factors emerged, together with many formative requests from the adolescents. On the basis of such results, we were able to create ad hoc preventive interventions. The proposed strategy seems to be potentially valid; however, we will be able to express a more precise judgment only at the end of the implementation phase.
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Affiliation(s)
- D Sarasino
- Catt. di Igiene, Università del Piemonte Orientale Amedeo Avogadro, Fac. di Medicina e Chirurgia, Novara
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Panella M, Kozel D, Marchisio S, Sarasino D, Pavanello PP, Jussich G, Di Stanislao F. [Autopsy today: an obsolete practice or an instrument for improving the quality of health care?]. Pathologica 2000; 92:58-64. [PMID: 10838869] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION Autopsies are a fundamental moment of clinical audit that have been progressively decaying. MATERIALS AND METHODS The autoptic rates of 6 hospitals of Piedmont Region (1639 autopsies, years 1995-97) were calculated. The Positive Predictive Value and Sensitivity (indicators of concordance between clinical and autoptic diagnosis) were calculated for each diagnosis; all discrepancies were classified as type I (adverse impact on patient's survival) and type II (uncertain impact) clinical errors. The diagnostic performance of medical, surgical and emergency staffs were compared with one another. RESULTS Autopsies are rarely performed on the patients who died in hospital (7.13%). Independently from the diagnosis, the global concordance expresses a Positive Predictive Value of 37.22% and a Sensitivity of 47.71%. 401 type I errors and 307 type II errors were found. The best performance is reached by emergency staff. AIM To evaluate the use and the meaning of autopsies in today's Italian healthcare organisations.
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Affiliation(s)
- M Panella
- Cattedra di Igiene, Università del Piemonte Orientale A. Avogadro, Facoltà di Medicina e Chirurgia di Novara.
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Bosetti M, Ottani V, Kozel D, Raspanti M, De Pasquale V, Ruggeri A, Cannas M. Structural and functional macrophages alterations by ceramics of different composition. Biomaterials 1999; 20:363-70. [PMID: 10048409 DOI: 10.1016/s0142-9612(98)00177-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Biomaterials may initiate several and complex biological reactions in host tissues, and the cell-biomaterial interactions can determine the release of mediators including monocytes and lymphocytes chemotactic factors. The present work was aimed to investigate in vitro the macrophage biological reactions of a natural apatite obtained by heat treatment at 400 degrees C of bovine bone, compared to other ceramics usually used for dental and orthopedic applications, using synthetic apatite and three types of alumina as controls. Particles chemotactic activity and powders oxidative burst evidenced no monocyte macrophages sensitivity reaction for natural and synthetic hydroxyapatite powders at great granulometry (> 50 microm); data were confirmed by ultrastructural observations; electron microscopy analysis showed macrophages with the features of healthy cells in the presence of both natural and synthetic apatites while macrophages grown in the presence of alumina seemed to be negatively affected. In conclusion, among all ceramics tested, natural apatite displayed a good compatibility with living cells, being better tolerated than synthetic hydroxyapatite which in turn is better tolerated than alumina.
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Affiliation(s)
- M Bosetti
- Department of Medical Sciences, Human Anatomy, University of Torino, Medical School of Novara, Italy
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