Evaluation of serum interleukin‐1 receptor antagonist levels in major depressive disorder: A case‐control study

Background and Aims

Major depressive disorder (MDD) is characterized by the occurrence of one or more depressive episodes lasting a minimum of 2 weeks and is marked by a persistently low mood and a lack of enjoyment in daily activities. The diagnosis of MDD is not possible by a well‐established laboratory test or biomarker. A wide range of potential biomarkers for depression have been proposed by many studies, but none of them has adequately described the correlation between the biomarkers and depression. The purpose of this study was to evaluate serum interleukin‐1 receptor antagonist (IL‐1RA) levels as an early depression risk factor.

Methods

The present case‐control study included 88 participants. Among them, 44 MDD patients enrolled from the psychiatry department of a public hospital in Dhaka, Bangladesh, and 44 age‐ and sex‐matched healthy controls (HCs) from various sites in Dhaka city. A qualified psychiatrist evaluated the cases and HCs based on the fifth edition of the diagnostic and statistical manual of mental disorders (DSM‐5). The Hamilton depression (Ham‐D) rating scale was employed to evaluate the intensity of depression. An enzyme‐linked immunosorbent assay kit (Boster Bio, USA) was used to determine serum IL‐1RA concentrations.

Results

We observed no marked alteration in the serum concentration of IL‐1RA in MDD patients in comparison to HCs (292.81 ± 24.81 and 288 ± 24.87 pg/mL; p > 0.05). Among MDD patients, we found no noteworthy association between the severity of depression and serum IL‐1RA levels.

Conclusion

The findings of the present study imply that IL‐1RA may not be identified as a promising biomarker for risk assessment of depression. However, its neuroprotective role may be taken into consideration for the understanding of pathophysiology of MDD.

Elevated Serum Macrophage Migration Inhibitory Factor Levels are Associated With Major Depressive Disorder

Background

Previous studies have suggested the involvement of an activated inflammatory process in major depressive disorder (MDD), as altered expression of inflammatory cytokines is observed in depression. This alteration can be the cause or a consequence of MDD. However, acknowledging inflammatory cytokines as prospective biomarkers would aid in diagnosing or guiding better therapeutic options. Therefore, we designed this study to assess the macrophage migration inhibitory factor (MIF) in depression.

Method

We collected blood samples from 115 MDD patients and 113 healthy controls (HCs) matched by age and sex. MDD patients were diagnosed by a qualified psychiatrist based on the symptoms mentioned in the diagnostic and statistical manual of mental disorders (DSM-5). We applied the Hamilton depression (Ham-D) rating scale to assess the severity of depression. We assessed serum levels of MIF using ELISA kit (Boster Bio, USA).

Result

We detected increased serum MIF levels in MDD patients compared to HCs (6.15 ± 0.23 ng/mL vs 3.95 ± 0.21 ng/mL, P < 0.001). Moreover, this increase is more among female patients than female controls. Also, we noticed a positive correlation between altered MIF levels and the Ham-D scores (r = 0.233; P = 0.012), where we found that patients who scored higher on the Ham-D scale had higher MIF levels in serum. Moreover, the area under the curve (AUC) of receiver operating characteristic (ROC) curve represented the good diagnostic performance of altered serum MIF.

Conclusion

Our study findings indicate the association of pro-inflammatory cytokine MIF in the pathophysiology of depression as we identified elevated serum MIF levels in depressive patients compared to HCs. However, more researches are required to confirm whether this alteration of cytokine is the causative factor or a consequence of depression. We recommend conducting further studies to understand the pattern of this alteration of MIF levels in MDD patients.

Higher serum interleukin-12 levels are associated with the pathophysiology of major depressive disorder: A case-control study results

Background and Aims

Major depressive disorder (MDD) is the fourth biggest health-related concern that dramatically impacts individuals' mental and physical health. Alteration of serum proinflammatory cytokine levels may take part in the development and progression of MDD. We aimed to explore and compare the role of interleukin-12 (IL-12) in MDD patients and healthy controls (HCs) and its involvement with the disease severity.

Methods

The present study included 85 patients and 87 age-sex matched HCs. A qualified psychiatrist utilized the diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) criteria to diagnose patients and evaluate HCs. We applied the Ham-D rating scale to measure the severity of depression. Serum IL-12 levels were measured using ELISA kits.

Results

We observed a notable increase in the serum levels of IL-12 in MDD patients compared to HCs (164.27 ± 10.18 pg/ml and 82.55 ± 4.40 pg/ml; p < 0.001). Moreover, we noticed a positive correlation between serum IL-12 levels and Ham-D scores in MDD patients (r = 0.363; p = 0.001). Receiver operating characteristic analysis showed a good predictive performance (AUC = 0.871; p < 0.001) at the cut-off point of 53.46 pg/ml for serum IL-12.

Conclusion

The current study findings support that IL-12 levels are involved with the pathogenesis and inflammatory process in MDD. At the same time, this involvement may make this cytokine eligible for the risk evaluation of MDD. However, we recommend further interventional studies to explore more accurate associations between IL-12 and depressive disorder.

Adaptation and validation of Bangla version of Premature Ejaculation Diagnostic Tool

Premature Ejaculation is one of the most common causes of male sexual dysfunction with prevalence rate of 20 % to 30% in different studies across the world. Premature ejaculation causes severe anxiety, embarrassment, and depression and relational conflicts. Diagnosing Premature Ejaculation can be problematic due to multidimensional nature of the disease. Premature Ejaculation Diagnostic Tool (PEDT) is a psychometrically valid tool for this purpose. This was a cross-sectional, analytical study and was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The English version of the PEDT was forward and back translated. An expert committee reviewed the translations and shared their feedbacks and opinions regarding the proposed Bangla questionnaire. Bangla version of Premature Ejaculation Diagnostic Tool was applied to 51 patients after obtaining informed consent. The test was undertaken again after seven days. Validity (Content validity, Face validity, Factor analysis) and reliability (Internal consistency, and test–retest reliability) were assessed. The expert committee expressed their satisfaction regarding Face and Content valid- ity of the questionnaire. Factor Analysis by Principal Component Analysis revealed that the questionnaire had high level of commonalities among the items and yielded a single compo- nent model like the original version. Cronbach's Alpha () value of 0.827 indicated good level of internal consistency. Intra-class Correlation Coefficient and Spearman's rho (0.94 and 0.87 respectively) indicated significant correlation between test and retest scores. Results were congruent with findings of similar studies. The Bangla version of PEDT is a valid and reliable scale. It will help to identify patient suffering from premature ejaculation and improve quality of life of the patient and his partner. BSMMU J 2021; 14(4): 132-137

Increased serum resistin but not G-CSF levels are associated in the pathophysiology of major depressive disorder: Findings from a case-control study

Background

Many studies have predicted major depressive disorder (MDD) as the leading cause of global health by 2030 due to its high prevalence, disability, and illness. However, the actual pathophysiological mechanism behind depression is unknown. Scientists consider alterations in cytokines might be tools for understanding the pathogenesis and treatment of MDD. Several past studies on several inflammatory cytokine expressions in MDD reveal that an inflammatory process is activated, although the precise causes of that changes in cytokine levels are unclear. Therefore, we aimed to investigate resistin and G-CSF in MDD patients and controls to explore their role in the pathogenesis and development of depression.

Methods

We included 220 participants in this study. Among them, 108 MDD patients and 112 age-sex matched healthy control (HCs). We used DSM-5 to evaluate study participants. Also, we applied the Ham-D rating scale to assess the severity of patients. Serum resistin and G-CSF levels were measured using ELISA kits (BosterBio, USA).

Results

The present study observed increased serum resistin levels in MDD patients compared to HCs (13.82 ± 1.24ng/mL and 6.35 ± 0.51ng/mL, p <0.001). However, we did not find such changes for serum G-CSF levels between the groups. Ham-D scores showed a significant correlation with serum resistin levels but not G-CSF levels in the patient group. Furthermore, ROC analysis showed a fairly predictive performance of serum resistin levels in major depression (AUC = 0.746).

Conclusion

The present study findings suggest higher serum resistin levels are associated with the pathophysiology of MDD. This elevated serum resistin level may serve as an early risk assessment indicator for MDD. However, the role of serum G-CSF in the development of MDD is still unclear despite its neuroprotective and anti-inflammatory effects.

Suicidal Behaviors among Patients Attending for Psychiatric Care in a Tertiary Care Hospital of Bangladesh

Suicide is a major preventable public health problem globally however, under attended in Bangladesh. It happens because of multi-factorial involvement; nevertheless, past suicidal attempt is a significant predictor of future suicidal behavior. We aimed to assess the suicidal behaviors among the patients visiting for psychiatric care in a tertiary care hospital of Bangladesh. This cross-sectional study was conducted among the patients attending at department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, from March 2018 to February 2019. A total of 379 patients were interviewed with pre-tested semi structured questionnaire. Non probability purposive sampling was used to collect data. Data were entered into Statistical Package for the Social Sciences 16.0 software and analyzed Among the 379 respondents, 197(52%) were male, 52.5% were married. Mean±SD age of the respondents was 29.94±11.32 year ranging from 18 to 75 years. About 24% percent of the respondents had family history of mental illness, 4% had family history of completed suicides. Prevalence of life time suicidal ideation among the patients was found as 32.5%, one-year prevalence rate 26.4%, one month 17.2% and within last two days it was found as 11.3%. The rate of suicidal plan was 14.0%, preparation 10.0% and attempt was 7.4%. Mean±SD age of onset of suicidal ideation was 24.33±8.9 year ranging from 14 to 57 years. About one in three psychiatric patients had life time suicidal ideation. Third decade of life was found to be vulnerable for onset of suicidal thoughts.

Cultural Variations in Symptom Presentations of Depression: A Cross-sectional Observation in a Tertiary Care Hospital of Bangladesh

Depression is a normally occurring, severe, repeated disorder associated to diminished role functioning and quality of life, medical morbidity, and mortality. But presentation of depression differs culture to culture. We aimed to see the proportion of depressed patients presented spontaneously with the somatic complaints at department of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. This descriptive, cross sectional study was conducted within the time period of June 2016 to December 2017 among the outdoor patients of the university. Purposive consecutive sampling was used to collect data from 105 depressed patients. The diagnosis was confirmed by the psychiatrist based on the DSM-5 criteria of depression. Data were collected through face to face interview with semi structured preformed pretested questionnaire. All data were entered into SPSS 16.0 software and were analyzed. The mean±SD age was 32.09±12.13 years, ranging from 18 to 70 years. Among the 105 respondents 36% of the depressive patients had complaints of somatic symptoms spontaneously. Headache (34.21%), weakness (2%), body ache (5%), hearing problem, heaviness of the body, restlessness, chest pain, palpitation, dizziness, vertigo, breathlessness, abdominal discomfort and burning sensation were the mentionable symptoms. Fear (11), anger (2), undue suspiciousness (2) & sexual dysfunction were the mentionable psychological symptoms. Due to multiple factors depressed patients can spontaneously present with somatic complaints, but after questioning on depression they can be diagnosed as depression. So, unexplained somatic symptoms should be attended and addressed properly in any stage of care.

Psychiatric Morbidities among Male Juvenile Offenders: A Cross Sectional Comparison in Bangladesh

Inmates of Juvenile Developmental Centers are the special group of youth population who are in conflict with law and are vulnerable to psychiatric disorders. It was aimed to see the variation of prevalence and type of psychiatric disorders in institutionalized male juvenile offenders and non-offenders of same age, sex and socioeconomic group in the community. The association of mental disorders was examined in 138 male inmates of Juvenile Development Centers and 138 randomly selected comparison subjects in community. One stage-structured assessment of psychopathology was carried out by using a structured and valid Bangla version of the Development and Well-Being Assessment (DAWBA). Psychiatric diagnosis was established after scoring from DAWBA that is actually corresponds to diagnosis of ICD-10 for research. It was revealed that, of those who were in conflict with law, 57.2% had mental disorder, whereas 9.4% of non-offenders had psychiatric disorder. Among the offenders with psychiatric disorders, most of them (16.7%) suffered from Conduct Disorder (CD), followed by Major Depressive Disorder (MDD). On the other hand, among the non-offenders with psychiatric disorder 2.2% suffered from CD. Study revealed that psychiatric disorders are more prevalent among the male juvenile offenders with comparison to non-offenders. Broad-based multi centered and cross cultural replication study can generalize the findings.

Prevalence of Psychiatric Disorders among Female Juvenile Offenders

Inmates of Juvenile Developmental Centers are the special group of youth population who are in conflict with law. They are vulnerable to psychiatric illness. The objective of this study was to see the prevalence and type of psychiatric disorders in institutionalized female juvenile offenders and non-offenders of same age, sex and socioeconomic group in the community. The association of mental disorders was examined in 43 female inmates of Juvenile Development Centers and 43 randomly selected comparison subjects in community. One stage-structured assessment of psychopathology was carried out by using a structured and valid Bangla version of the Development and Well-Being Assessment (DAWBA). Development and Well-Being Assessment generated psychiatric diagnosis was assigned based on ICD-10 diagnostic criteria for research. The result revealed that, of those who were in conflict with law, 93% had mental disorder, whereas 14% of non-offenders had psychiatric disorder. Among the offenders with psychiatric disorders, most of them (32.6%) suffered from Major Depressive Disorder (MDD), followed by combined MDD & Post Traumatic Stress Disorder (PTSD). On the other hand, among the non-offenders with psychiatric disorder 9.3% suffered from MDD. It can be concluded that considerable psychiatric disorders are prevalent among the female juvenile offenders with comparison to non-offenders. Broad-based replication study could confirm these findings.