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Buspavanich P, Adli M, Himmerich H, Berger M, Busche M, Schlattmann P, Bopp S, Bschor T, Richter C, Steinacher B, Stoppel C, Hindinger C, Meyer S, Hoffmann K, Stamm T, Gabriel A, Merkl A, Goerke-Arndt F, Köhler S, Sterzer P, Heinz A, Behr J, Fakhri H, Lang F, Lang UE, Ricken R. Faster speed of onset of the depressive episode is associated with lower cytokine serum levels (IL-2, -4, -6, -10, TNF-α and IFN-γ) in patients with major depression. J Psychiatr Res 2021; 141:287-292. [PMID: 34271459 DOI: 10.1016/j.jpsychires.2021.06.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 06/12/2021] [Accepted: 06/15/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Cytokines might play a key role in the pathophysiology of major depressive disorder (MDD). The speed of onset of depressive episodes has been discussed as an important clinical parameter in MDD. The aim of this study was to investigate a potential influence of the speed of onset of the depressive episode on cytokine serum levels. METHOD Serum level of the cytokines interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor alpha (TNF-α), interferon-gamma (IFN-γ) granulocyte and monocyte colony stimulating factor (GM-CSF) were measured in a total of 92 patients with MDD that did not respond to at least one previous antidepressant treatment. Patients were retrospectively divided in two groups: Faster (≤4 weeks) and slower (>4 weeks) onset of the depressive episode defined as the time passing from the first depressive symptoms to a full-blown depressive episode by using information from a clinical interview. RESULTS We found significantly lower serum levels of IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ in patients with a faster onset compared to patients with a slower onset of the depressive episodes. Furthermore, lower cytokine serum levels of IL-2, IL-8, IL-10 and IFN-γ were found in patients with a shorter duration (less than 6 months) compared to a longer duration (6-24 months) of the current depressive episode. This effect on cytokines was independent from the effect of the speed of onset of the depressive episode. CONCLUSIONS Patients with faster onset of the depressive episode might represent a biological subtype of MDD with lower serum levels of IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ.
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Affiliation(s)
- Pichit Buspavanich
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Mazda Adli
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany; Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany
| | - Hubertus Himmerich
- Department of Psychological Medicine, King's College London, London, United Kingdom; Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Maximilian Berger
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Marlene Busche
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Peter Schlattmann
- Department of Statistics, Informatics and Data Science, Jena University Hospital, Jena, Germany
| | - Sandra Bopp
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Tom Bschor
- Department of Psychiatry and Psychotherapy, Technical University of Dresden Medical School, Dresden, Germany
| | - Christoph Richter
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany; Department of Psychiatry and Psychotherapy, Vivantes Klinikum Kaulsdorf, Berlin, Germany
| | - Bruno Steinacher
- Department of Psychiatry and Psychotherapy, Vivantes Wenckebach-Klinikum, Berlin, Germany; Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
| | - Christian Stoppel
- Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
| | - Claudia Hindinger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Saskia Meyer
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Kai Hoffmann
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Thomas Stamm
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Alexander Gabriel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Angela Merkl
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany; Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany
| | | | - Stephan Köhler
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Phillip Sterzer
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Joachim Behr
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany; Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany; Research Department of Experimental and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Mitte, Germany
| | - Hajar Fakhri
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | - Florian Lang
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | - Undine E Lang
- Department of Psychiatry and Psychotherapy, University Psychiatric Clinics, Basel, Switzerland
| | - Roland Ricken
- Department of Psychiatry and Psychotherapy, Charité -Universitätmedizin Berlin, Campus Mitte, Berlin, Germany.
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Ricken R, Bopp S, Schlattmann P, Himmerich H, Bschor T, Richter C, Elstner S, Stamm TJ, Schulz-Ratei B, Lingesleben A, Reischies FM, Sterzer P, Borgwardt S, Bauer M, Heinz A, Hellweg R, Lang UE, Adli M. Ghrelin Serum Concentrations Are Associated with Treatment Response During Lithium Augmentation of Antidepressants. Int J Neuropsychopharmacol 2017; 20:692-697. [PMID: 28911006 PMCID: PMC5581484 DOI: 10.1093/ijnp/pyw082] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 10/28/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Lithium augmentation of antidepressants is an effective strategy in treatment-resistant depression. The proteohormone ghrelin is thought to be involved in the pathophysiology of depression. The purpose of this study was to investigate the association of treatment response with the course of ghrelin levels during lithium augmentation. METHOD Ghrelin serum concentrations and severity of depression were measured in 85 acute depressive patients before and after 4 weeks of lithium augmentation. RESULTS In a linear mixed model analysis, we found a significant effect of response*time interaction (F1.81=9.48; P=.0028): under treatment, ghrelin levels increased in nonresponders and slightly decreased in responders to lithium augmentation. The covariate female gender had a significant positive effect (F1.83=4.69; P=.033), whereas time, response, appetite, and body mass index (kg/m2) did not show any significant effect on ghrelin levels (P>.05). CONCLUSION This is the first study showing that the course of ghrelin levels separates responders and nonresponders to lithium augmentation. Present results support the hypothesis that ghrelin serum concentrations might be involved in response to pharmacological treatment of depression.
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Affiliation(s)
- Roland Ricken
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor).,Correspondence: Roland Ricken, MD, Department of Psychiatry and Psychotherapy Charité – Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany ()
| | - Sandra Bopp
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Peter Schlattmann
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Hubertus Himmerich
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Tom Bschor
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Christoph Richter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Samuel Elstner
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Thomas J Stamm
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Brigitte Schulz-Ratei
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Alexandra Lingesleben
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Friedel M Reischies
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Philipp Sterzer
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Rainer Hellweg
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Undine E Lang
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Mazda Adli
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
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