Depression
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Publication
Journal: The Journal of comparative neurology
November/30/2019
Abstract
The pathogenesis of fibromyalgia is still unknown. Core symptoms include pain, depression and sleep disturbances with high comorbidity, suggesting alterations in the monoaminergic system as a common origin of this disease. The reserpine-induced myalgia model (RIM) lowers pain thresholds and produces depressive-like symptoms. The present work aims to evaluate temporal dynamics in the oscillatory profiles and motor activity during sleep in this model and to evaluate if the model mimics the sleep disorders that occur in fibromyalgia patients. Hippocampal and EMG activity were recorded in chronically implanted rats. Following 3 days of basal recordings, reserpine was administered on 3 consecutive days to achieve the RIM. Post-reserpine recordings were taken on alternate days for 21 days. Reserpine induced changes in the sleep architecture with more transitions between states, and a different pattern between the administration period and post-reserpine weeks. Administration days were characterized by a larger amount of REM sleep with dominant theta waves without atonia. Following the reserpinization, theta oscillations were always more fragmented and with lower frequency. On the post-reserpine days, sleep was dominated by slow-wave sleep with fast intrusions and reduced hierarchical coupling with spindles and ripples. Simultaneous electromyography recordings also showed muscle twitches during sleep and the dissociation of theta activity and muscle atonia. Abnormally high slow waves, alpha/delta intrusions, frequent transitions and muscle twitches are common traits in fibromyalgia. Therefore, our analyses support the validity of the reserpine-induced myalgia model to study sleep disorders in fibromyalgia, and provide new insights into the research of oscillographic biomarkers. This article is protected by copyright. All rights reserved.
Publication
Journal: Oxidative medicine and cellular longevity
November/27/2019
Abstract
Generally, depression is the result of complex gene-environment interactions. Recent studies have showed that the gut microbiota can affect brain function through the microbiota-gut-brain axis. However, the underlying mechanism of the microbiota and potential influence of depression remain elusive. We aimed to determine how gut microbiome contributes to the process of depression and further influences the host. Chronic unpredictable mild stress (CUMS) is used to establish a depression model. Fecal microbiota transplant (FMT) is applied to illustrate that depression can be transmitted via microbiota, and metabolism of liver analysis is applied to demonstrate further influence to the liver. We also analyzed the astrocyte activation in the brain by immunofluorescence (IF). Here, we show that the structure of the gut microbiome changes markedly after rats undergo CUMS. Notably, we found that the ratio of Lactobacillus to Clostridium can be a vital index for the development of depression. Depression-like behavior can be duplicated through FMT. Moreover, increased zonulin and fatty acid binding protein-2 indicates that gut barrier integrity is broken after FMT. Subsequently, metabolomics shows that liver metabolic disorder occurs and leads to liver coagulative necrosis. In addition, increased inflammatory cytokine expression and higher astrocyte activation indicate an inflammatory process in the brain. These findings suggest that dysbiosis gut microbiome contributes to development of depression and further causes liver metabolic disorders in a way that may be relevant to the Lactobacillus to Clostridium ratio.
Publication
Journal: Journal of clinical anesthesia
November/25/2019
Abstract
The aim of this study was to compare methadone and morphine for the management of postoperative.Open, controlled study.Postoperative recovering area, ward.Sixty-four patients, ASA I-III, undergoing gynecological surgery for cancer.Morphine or methadone 0.15 mg/kg given preoperatively. After operation an intravenous morphine or intravenous methadone infusion at doses of 12 mg/day was started.Pain intensity and opioid consumption.Methadone infusion provided a better analgesia in comparison with morphine infusion on the second day. Opioid consumption was significantly lower in the methadone group. No episodes of relevant desaturation or signs of respiratory depression were recorded.A preoperative bolus of methadone, followed by a continuous infusion of low doses post-operatively, provided a better analgesia, without adding risk of adverse effects, in comparison with morphine.
Publication
Journal: Medicine
November/25/2019
Abstract
Sleep deprivation is a common phenomenon among older population and is commonly linked to behavioral, physiological, and psychosocial factors. Not much is known about sleep deprivation among older population in Africa. Therefore, in this study we aimed to investigate the basic sociodemographic and psychosocial predictors of self-reported sleep deprivation among older population.In this study we analyzed cross-sectional data on 1495 community dwelling men and women aged 50 years and above. Data were collected from the SAGE Well-Being of Older People Study conducted in South Africa and Uganda. Outcome variable was self-reported sleep difficulty last 30 days. Multivariable logistic regression models were used to identify the variables significantly associated with sleep difficulty.The prevalence of mild-moderate sleep difficulty was 32.6% (27.9, 37.6) and severe/extreme 23.0% (20.3, 26.0) respectively. Multivariable analysis revealed that sleep difficulty was associated with several behavioral, environment, and illness conditions. In South Africa, those who reported dissatisfaction with living condition had 1.592 [1.087, 2.787] times higher odds of reporting mild/moderate sleep difficulty. Poor subjective quality of life (QoL) was associated with higher odds of severe/extreme sleep difficulties (odds ratios [OR] = 4.590, 95% confidence interval [CI] = 2.641, 7.977 for South Africa, and OR = 4.461, 95% CI = 2.048 and 9.716 for Uganda). In Uganda, perceived depression was associated with higher odds of severe/extreme (OR = 2.452, 95% CI = 1.073, 5.602) sleep difficulties among men, and both mild/moderate (OR = 1.717; 95% CI = 1.011, 2.914) and severe/extreme sleep difficulties among women (OR = 2.504, 95% CI = 1.408, 4.453).More than half of the participants had sleep difficulty of certain degrees, emphasising an urgent need for intervention for sleep deprivation in the population. Interventions targeting to promote subjective health, quality of life, and living environment may prove beneficial for improving sleep health in this regard.
Publication
Journal: Behavioural brain research
November/25/2019
Abstract
Changes in the gut microbiota have been implicated in mood and cognition. In rodents, supplementation with certain bacteria have been shown to alleviate adverse effects of stress on gut microbiota composition and behaviour, but little is known of how the performance of different strains compare to each other. We took a systematic approach to test the efficacy of twelve candidate probiotic strains from ten species/sub-species ofBifidobacterium and Lactobacillus on behaviours and neuroendocrine responses of chronically stressed mice.

METHODS
The strains were tested in four screening experiments with non-stressed and chronically stressed vehicle groups. The three most efficacious strains were re-tested to validate the results. Mice were administered a daily oral gavage containing either 1 × 109 colony forming units of selected candidate probiotic or saline solution for one week prior to and for three weeks during daily chronic restraint stress. Behavioural tests including the elevated plus maze, open field, novel object recognition, and forced swim test were applied during week five. Corticosterone and adrenocorticotropic hormone (ACTH) were analysed to measure the neuroendocrine response to stress. Plasma and tissue samples were collected for biomarker analyses.

Of the twelve candidate probiotics,Lactobacillus paracasei Lpc-37, Lactobacillus plantarum LP12407, Lactobacillus plantarum LP12418 and Lactobacillus plantarum LP12151 prevented stress-associated anxiety and depression-related behaviours compared with chronically stressed vehicle mice. In addition, Lpc-37 improved cognition.This systematic screening indicates species- and strain-dependent effects on behavioural outcomes related to stress and further suggests that strains differ from each other in their effects on potential mechanistic outcomes.
Publication
Journal: European review for medical and pharmacological sciences
November/22/2019
Abstract
The use of long-term opioids for the management of chronic musculoskeletal pain is a hot topic in the scientific community, especially when it concerns the elderly. This paper aimed at assessing the efficacy and tolerability of tapentadol prolonged release (PR), a molecule with a unique mechanism of action combining μ-opioid-receptor (MOR) agonism and noradrenaline reuptake inhibition (NRI), administered to patients aged ≥80 years with chronic persistent pain. The effect of this molecule on anxiety, depression, cognitive status, and overall quality of life were investigated.This was a spontaneous, observational, open-label, prospective study, in 80 older patients aged ≥80 years, naïve to strong opioids, presenting moderate-to-severe chronic pain from different etiologies. Tapentadol PR was initially prescribed at the dose of 25-50 mg/day and increased gradually in case of insufficient analgesia. Pain intensity was assessed by a 10-point Numeric Rating Scale (NRS). Other endpoints were as follows: DN4 questionnaire for the evaluation of the neuropathic component of pain, SF12, HADS, and MMSE questionnaires to evaluate the quality of life, anxiety, and cognitive impairment, respectively. Safety evaluations were also performed through the assessment of the frequency and severity of adverse events.At T45, NRS score reduction was achieved in 86.0% of patients. On average, pain decreased by 55% from a mean of 8.2 to a mean of 3.6. At T90, tapentadol PR did not affect the psychophysical and cognitive abilities of older patients.The benefits with tapentadol PR in controlling pain have improved the quality of life of our patients, also showing a favorable effect on their cognitive performance.
Publication
Journal: Bioscience, biotechnology, and biochemistry
November/20/2019
Abstract
Royal jelly (RJ) is used as a dietary supplement for human health promotion. Recently, a clinical trial has reported that RJ improved mental health. The present study was conducted to experimentally support the clinical effect of RJ on mental health and to further elucidate the mechanisms of action of RJ. RJ and an ethanol extract of RJ, which contains fatty acids but not proteins, inhibited an unpredictable chronic mild stress (UCMS)-induced increase in immobility time, a depression-like behavior, in the tail suspension test. DNA microarray analysis of the adrenal grand revealed that the expression of genes involved in cholesterol metabolism was up-regulated in response to UCMS exposure and that RJ suppressed expression of genes related to cholesterol synthesis and transport. These results suggested that RJ improves stress-induced depression-like behavior by regulating adrenal steroidogenesis and that fatty acids contained in RJ partly contribute to the antidepressant effect of RJ.
Publication
Journal: Frontiers in psychology
November/18/2019
Abstract
It is unknown whether lowered steady state levels of sex hormones coupled with changes in those hormones during the menstrual cycle are associated with premenstrual syndrome (PMS).To examine associations between levels of progesterone and oestradiol during the menstrual cycle and PMS considering different diagnostic criteria for PMS.Forty-one women aged 18-45 years with a regular menstrual cycle completed the Daily Record of Severity of Problems (DRSP) for all 28 consecutive days of the menstrual cycle. Blood was sampled at days 7, 14, 21, and 28 to assay oestradiol and progesterone.We developed a new diagnosis of peri-menstrual syndrome, which is characterized by increased DRSP severity in pre and post-menstrual periods and increased scores on the major DRSP dimensions, i.e., depression, physio-somatic symptoms, breast tenderness and appetite, and anxiety. This new diagnosis performed better than classical diagnoses of PMS, including that of the American College of Obstetricians and Gynecologists (ACOG). Lowered steady state levels of progesterone, when averaged over the menstrual cycle, together with declining progesterone levels during the luteal phase predict severity of peri-menstrual symptoms. Steady state levels of oestradiol and declining oestradiol levels during the cycle are also related to DRSP severity although most of these effects appeared to be mediated by progesterone.A significant increase in menstrual-cycle related symptoms can best be conceptualized as "peri-menstrual syndrome" and may result from insufficient progesterone production (relative corpus luteum insufficiency), which, in part may result from lowered oestradiol production indicating suboptimal pre-ovulatory follicular development.
Publication
Journal: Turkish journal of medical sciences
November/15/2019
Abstract
Our purpose was to determine the efficacy of levodopa carbidopa intestinal gel (LCIG) in a series of Turkish patients with Parkinson?s disease (PD).We had telephone calls with 44 patients from 11 neurology centers who were on LCIG treatment were included in an eight items survey between September 2015 and June 2016. The reliability and validity of the survey were evaluated with intra-class correlation coefficient on every question separately.Average age of the patients were 63.48 and duration of PD was 12.79 years. Average LCIG treatment period was 15.63 months. Percentages of the patients who reported they were `better? after LCIG treatment were: 80% for time spent in off, 55% for dyskinesia, 65% for tremor, 85% for gait disorder, 50% for pain, 50% for sleep disorders, 42.5% for depression, 32.5% for incontinence, and 70% for activities of daily living. Cronbach?s alpha was 0.795 and also, intraclass correlation coefficient (ICC) was reliably for the items.As it is detected by a survey performed by telephone calls with good interrater reliability, patients with PD gets better with LCIG treatment in many aspects of the disease.
Publication
Journal: Journal of Taibah University Medical Sciences
November/15/2019
Abstract

Objective
This study aimed to determine the allelic and genotypic association of the Val66Met (rs6265) polymorphism in the BDNF gene with stress levels in preclinical medical students of Universiti Sultan Zainal Abidin (UniSZA), Terengganu, Malaysia.

Methods
In this cross-sectional study, we recruited all 122 preclinical medical students. The validated depression anxiety stress scales-21 (DASS-21) questionnaire was distributed and blood samples were collected from each subject for DNA extraction. Genotyping analysis of the BDNF gene (Val66Met) polymorphism was performed via an optimised polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.

Results
A total of 105 subjects agreed to participate in this study. Indian students were found to more likely have the Val/Val genotype, whereas Malay students were more likely to have the Met/Met genotype (p = 0.027). Individuals carrying any one of the three BDNF genotypes (Val/Val, Val/Met and Met/Met) differed significantly from each other in terms of their perception of stress (p = 0.010); students carrying the Val/Val genotype (M = 10.6) perceived significantly lower stress than students carrying the Val/Met (M = 14) and Met/Met (M = 15.1) genotypes.

In our study, the Met-allele was associated with higher stress levels. To the best of our knowledge, this is the first study investigating this stress-related gene in medical students. The findings from this study should trigger more investigators to focus on the impact of stress on genetically predisposed medical students.
Publication
Journal: Psychotherapy research : journal of the Society for Psychotherapy Research
November/14/2019
Abstract
AbstractThere is a great need to identify predictors of treatment response, and the analysis of defense mechanisms is a promising approach. Defensive functioning may influence psychotherapy outcome in two ways: First, when it is generally higher or lower for some patients relative to others and second, as it shifts in individual patients over time. The present study examined both within- and between patient effects of defenses using hierarchical linear modeling. Forty-seven patients diagnosed with depression, anxiety, or adjustment disorders received 25 ± 3 sessions of integrative cognitive-behavioral therapy in a university outpatient clinic. The Defense Mechanism Rating Scale (DMRS) was used to assess defenses in the 1st, 8th, 16th, and 24th session and relate them to symptom severity of depression and anxiety. A higher number of adaptive defense mechanisms was associated with less severe depressive symptoms during treatment while a higher number of immature defenses was related to more severe depressive and anxiety symptoms. An increase in adaptive and a decrease in immature defenses over the course of treatment predicted symptom reduction of depression whereas a decrease in neurotic and immature defenses was associated with reductions in anxiety symptoms. Our results empirically support defensive functioning as a mechanism of change in psychotherapy.
Publication
Journal: Heart (British Cardiac Society)
November/8/2019
Abstract
To define trajectories of perceived health-related quality of life (HRQoL) among survivors of acute myocardial infarction (AMI) and identify factors associated with trajectories.Data on HRQoL among 9566 survivors of AMI were collected from 77 National Health Service hospitals in England between 1 November 2011 and 24 June 2015. Longitudinal HRQoL was collected using the EuroQol five-dimension questionnaire measured at hospitalisation, 1, 6 and 12 months post-AMI. Trajectories of perceived HRQoL post-MI were determined using multilevel regression analysis and latent class growth analysis (LCGA).One or more percieved health problems in mobility, self-care, usual activities, pain/discomfort and anxiety/depression was reported by 69.1% (6607/9566) at hospitalisation and 59.7% (3011/5047) at 12 months. Reduced HRQoL was associated with women (-4.07, 95% CI -4.88 to -3.25), diabetes (-2.87, 95% CI -3.87 to -1.88), previous AMI (-1.60, 95% CI -2.72 to -0.48), previous angina (-1.72, 95% CI -2.77 to -0.67), chronic renal failure (-2.96, 95% CI -5.08 to -0.84; -3.10, 95% CI -5.72 to -0.49), chronic obstructive pulmonary disease (-3.89, 95% CI -5.07 to -2.72) and cerebrovascular disease (-2.60, 95% CI -4.24 to -0.96). LCGA identified three subgroups of HRQoL which we labelled: improvers (68.1%), non-improvers (22.1%) and dis-improvers (9.8%). Non-improvers and dis-improvers were more likely to be women, non-ST-elevation myocardial infarction (NSTEMI) and have long-term health conditions, compared with improvers.Quality of life improves for the majority of survivors of AMI but is significantly worse and more likely to decline for women, NSTEMI and those with long-term health conditions. Assessing HRQoL both in hospital and postdischarge may be important in determining which patients could benefit from tailored interventions.NCT01808027 and NCT01819103.
Publication
Journal: Health communication
November/7/2019
Abstract
The Institute of Medicine has called for an increase in efforts to investigate the understudied area of LGBTQ health and relationships. This study furthers the research by illuminating social support predictors of positive relationship functioning and resilience from a large national sample of those in same-sex relationships (N = 1,303) who continue to face minority stigma and stress in society. Primary findings underscore the centrality of partner social support and the importance of combating depression in sustaining positive relationship outcomes (commitment, satisfaction, closeness, and couple resilience) in same-sex romantic relationships. Findings also may point to increasing social legitimacy of same-sex couples and less reliance on LGBTQ-specific social supportive environments. Future research is needed to further explore the personal and relational health of same-sex couples.
Publication
Journal: Psychiatria Danubina
November/7/2019
Abstract
To the best of our knowledge, no studies have been conducted in order to assess the correlation of these factors with the self-esteem in Lebanon. Therefore, this study aims to assess risk factors associated with self- esteem among a representative sample of the Lebanese population.A cross-sectional, conducted between November 2017 and March 2018, enrolled 789 participants. Self-esteem was measured using the Rosenberg scale. An exploratory factor analysis was executed to detect patterns of risk factors associated with self-esteem from our sample. A cluster analysis was then performed with the identified factor scores to identify the different profiles of the participants.Relationship management (Beta=0.117), emotional awareness (Beta=0.074) and personal accomplishment (Beta=0.064) were associated with a higher self-esteem, whereas high depression (Beta=-0.102), alexithymia (Beta=-0.077), burnout depersonalization (Beta=-0.078), suicidal ideation (Beta=-0.391) were associated with a lower self-esteem. Factor 1 (High emotional intelligence & low depersonalization) (Beta=1.819) was associated with increased self-esteem, whereas Factor 2 (High suicidal ideation, high alcohol dependence, high depression and anxiety) and Factor 3 (High burnout, high stress and high alexithymia) were associated with decreased self-esteem (Beta=-1.380 and Beta=-0.751) respectively. Being widowed (Beta=-2.332), belonging to cluster 1 (People with emotional dysregulation) (Beta=-2.850) and cluster 2 (People in distress) (Beta=-3.660) were significantly associated with decreased self-esteem.Depression, anxiety, burnout, stress, low emotional intelligence, alexithymia, suicide ideation, alcohol dependence and many other factors can be prevented, or reduced, by interventions that improve self-esteem.
Publication
Journal: JAMA oncology
November/7/2019
Abstract
Older patients with cancer and their caregivers worry about the effects of cancer treatment on aging-related domains (eg, function and cognition). Quality conversations with oncologists about aging-related concerns could improve patient-centered outcomes. A geriatric assessment (GA) can capture evidence-based aging-related conditions associated with poor clinical outcomes (eg, toxic effects) for older patients with cancer.To determine whether providing a GA summary and GA-guided recommendations to oncologists can improve communication about aging-related concerns.This cluster-randomized clinical trial enrolled 541 participants from 31 community oncology practices within the University of Rochester National Cancer Institute Community Oncology Research Program from October 29, 2014, to April 28, 2017. Patients were aged 70 years or older with an advanced solid malignant tumor or lymphoma who had at least 1 impaired GA domain; patients chose 1 caregiver to participate. The primary outcome was assessed on an intent-to-treat basis.Oncology practices were randomized to receive either a tailored GA summary with recommendations for each enrolled patient (intervention) or alerts only for patients meeting criteria for depression or cognitive impairment (usual care).The predetermined primary outcome was patient satisfaction with communication about aging-related concerns (modified Health Care Climate Questionnaire [score range, 0-28; higher scores indicate greater satisfaction]), measured after the first oncology visit after the GA. Secondary outcomes included the number of aging-related concerns discussed during the visit (from content analysis of audiorecordings), quality of life (measured with the Functional Assessment of Cancer Therapy scale for patients and the 12-Item Short Form Health Survey for caregivers), and caregiver satisfaction with communication about aging-related patient concerns.A total of 541 eligible patients (264 women, 276 men, and 1 patient did not provide data; mean [SD] age, 76.6 [5.2] years) and 414 caregivers (310 women, 101 men, and 3 caregivers did not provide data; mean age, 66.5 [12.5] years) were enrolled. Patients in the intervention group were more satisfied after the visit with communication about aging-related concerns (difference in mean score, 1.09 points; 95% CI, 0.05-2.13 points; P = .04); satisfaction with communication about aging-related concerns remained higher in the intervention group over 6 months (difference in mean score, 1.10; 95% CI, 0.04-2.16; P = .04). There were more aging-related conversations in the intervention group's visits (difference, 3.59; 95% CI, 2.22-4.95; P < .001). Caregivers in the intervention group were more satisfied with communication after the visit (difference, 1.05; 95% CI, 0.12-1.98; P = .03). Quality of life outcomes did not differ between groups.Including GA in oncology clinical visits for older adults with advanced cancer improves patient-centered and caregiver-centered communication about aging-related concerns.ClinicalTrials.gov identifier: NCT02107443.
Publication
Journal: Epilepsy & behavior : E&B
November/7/2019
Abstract
This study aimed to validate a Georgian version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). The distribution of psychiatric disorders was assessed among patients with epilepsy.One hundred and thirty consecutive adult patients with epilepsy completed the NDDI-E and the Beck Depression Inventory (BDI). All patients were further assessed by a qualified psychiatrist.In 31 (23.8%) patients, a diagnosis of major depression was revealed. The internal consistency of the NDDI-E was 0.695. Receiver operating characteristics (ROC) showed an area under the curve of 0.975. A cutoff score of ≥16 resulted in a sensitivity of 0.90 and a specificity of 0.939. The screening questionnaire showed a significantly positive correlation with BDI scores (Spearman's rho - 0.684), indicating good concurrent validity.The Georgian version of the NDDI-E is a reliable tool for the detection of depressive disorders in individuals with epilepsy.
Publication
Journal: The British journal of clinical psychology
November/7/2019
Abstract
Research largely supports the clinical effectiveness of low-intensity cognitive behavioural therapy (LICBT) for mild-to-moderate anxiety and depression, delivered by psychological well-being practitioners (PWPs). Knowledge regarding the predictors of treatment response, however, is relatively limited. The primary aim of this study was to model the heterogeneity in longitudinal changes in anxiety and depression throughout LICBT provided by PWPs in Northern Ireland (NI), and to explore associations between pre-treatment variables and differences in treatment response.Growth mixture modelling (GMM) techniques were employed to examine changes in psychological status in clients (N = 253) over the first six sessions of treatment, to identify divergent early response trajectories. A series of pre-treatment variables were used to predict class membership using chi-square tests and binary logistic regression models.There was one class representing improvement and one representing no improvement for both anxiety and depression. Class membership was predictive of treatment outcome. Pre-treatment variables associated with less improvement included unemployment, risk of suicide, neglect of self or others, using medication, receiving previous or concurrent treatments, a longer duration of difficulties, and comorbidities.Findings indicate most of the sample populated an 'improvers' class for both depression and anxiety. Pre-treatment variables identified as predictive of poor treatment response may need to be considered by practitioners in potential triage referral decision policies, supporting cost-effective and efficient services. Further research around predictors of clinical outcome is recommended.Most of the sample belonged to an 'improvers' class. Several pre-treatment variables predicted poor treatment response (unemployment, suicide risk, neglect, medication, previous or concurrent treatments, longer duration of difficulties, and comorbidities). Few studies have utilized GMM to determine predictors of outcome following LICBT Regarding pre-treatment variables, the possibility of self-report bias cannot be excluded. The time period was relatively short, although represented the optimum number of sessions recommended for LICBT. The lack of a control group and random allocation were the main limitations.
Publication
Journal: Annals of epidemiology
November/4/2019
Abstract
The purpose of the study was to determine the prevalence and odds of mental disorder diagnoses at discharge in U.S. transgender hospital encounters as compared with cisgender hospital encounters using nationally representative data.The National Inpatient Sample was used to identify 25,233 transgender and 254,437,363 cisgender inpatient encounters from 2007 to 2014. Univariate analyses were performed to compare the prevalence of mental disorders and comorbid medical diagnoses at the time of discharge. Multivariable analyses controlling for medical comorbid diagnoses were performed to assess the multivariable odds of mental disorder diagnoses in transgender versus cisgender hospital encounters. The prevalence of medical comorbid diagnoses in transgender encounters with and without mental disorder diagnoses was also compared.The prevalence of mental disorder diagnoses was higher in transgender hospital encounters (77% vs. 37.8%, P < .001). The prevalence of each examined mental disorder diagnosis was significantly higher in transgender hospital encounters. A multivariable analysis demonstrated significantly higher odds of all mental disorder diagnoses (odds ratio [OR] = 7.94; confidence interval [CI], 7.63-8.26; P < .001), anxiety (OR = 3.44; CI, 3.32-3.56; P < .001), depression (OR = 1.63; CI, 1.57-1.70; P < .001), and psychosis (OR = 2.46; CI, 2.36-2.56; P < .001) among transgender versus cisgender inpatient encounters. Transgender encounters with a mental disorder diagnosis had a higher prevalence of chronic medical comorbid diagnoses as compared with transgender encounters without mental disorder diagnoses.Our findings suggest a high prevalence and significantly higher odds of mental disorder diagnoses in the transgender population as compared with the cisgender population using data that are nationally representative of the U.S.
Publication
Journal: Neuropharmacology
November/4/2019
Abstract
Resilience to stress is critical for the development of depression. Enhanced adenosine A1 receptor (A1R) signaling mediates the antidepressant effects of acute sleep deprivation (SD). However, chronic SD causes long-lasting upregulation of brain A1R and increases the risk of depression. To investigate the effects of A1R on mood, we utilized two transgenic mouse lines with inducible A1R overexpression in forebrain neurons. These two lines have identical levels of A1R increase in the cortex, but differ in the transgenic A1R expression in the hippocampus. Switching on the transgene promotes robust antidepressant and anxiolytic effects in both lines. The mice of the line without transgenic A1R overexpression in the hippocampus (A1Hipp-) show very strong resistance towards development of stress-induced chronic depression-like behavior. In contrast, the mice of the line in which A1R upregulation extends to the hippocampus (A1Hipp+), exhibit decreased resilience to depression as compared to A1Hipp-. Similarly, automatic analysis of reward behavior of the two lines reveals that depression resistant A1Hipp-transgenic mice exhibit high sucrose preference, while mice of the vulnerable A1Hipp + line developed stress-induced anhedonic phenotype. The A1Hipp + mice have increased Homer1a expression in hippocampus, correlating with impaired long-term potentiation in the CA1 region, mimicking the stressed mice. Furthermore, virus-mediated overexpression of Homer1a in the hippocampus decreases stress resilience. Taken together our data indicate for first time that increased expression of A1R and Homer1a in the hippocampus modulates the resilience to stress-induced depression and thus might potentially mediate the detrimental effects of chronic sleep restriction on mood.
Publication
Journal: PeerJ
October/28/2019
Abstract
Purinergic receptors, especially P2RX, are associated to the severity of symptoms in patients suffering from depressive and bipolar disorders, and genetic deletion or pharmacological blockade of P2RX7 induces antidepressant-like effect in preclinical models. However, there is scarce evidence about the alterations in P2RX7 or P2RX4 levels and in behavioral consequences induced by previous exposure to stress, a major risk factor for depression in humans. In the present study, we evaluated the effect of imipramine (IMI) on P2RX7 and P2RX4 levels in dorsal and ventral hippocampus as well as in the frontal cortex of rats submitted to the pretest session of learned helplessness (LH) paradigm. Repeated, but not acute administration of IMI (15 mg/kg ip) reduced the levels of both P2RX7 and P2RX4 in the ventral, but not in dorsal hippocampus or frontal cortex. In addition, we tested the effect of P2RX7/P2RX4 antagonist brilliant blue G (BBG: 25 or 50 mg/kg ip) on the LH paradigm. We observed that repeated (7 days) but not acute (1 day) treatment with BBG (50 mg) reduced the number of failures to escape the shocks in the test session, a parameter mimicked by the same regimen of IMI treatment. Taken together, our data indicates that pharmacological blockade or decrease in the expression of P2RX7 is associated to the antidepressant-like behavior observed in the LH paradigm after repeated drug administration.
Publication
Journal: Behavioural brain research
October/26/2019
Abstract
Physical touch can help to decrease the effects of stress. The aim of this study was to evaluate the influence of tactile stimulation on the hormonal and behavioral responses of young adult rats submitted to chronic mild unpredictable stress (CMS), considering the role of angiotensin II (Ang II). In Experiment 1, male rats were divided into 4 groups: control, stress, tactile stimulation (TS), and stress + TS. CMS was applied for three weeks. Tactile stimulation was applied for seven weeks, five days a week. After the CMS protocol, depression-like behaviors were evaluated by forced swimming and sucrose consumption tests. Learning and memory were evaluated using the Y-maze test. Fifteen days after the CMS procedure, the animals were euthanized and the levels of stress hormones were determined. The hypothalamus was isolated for determination of the Ang II concentration. In Experiment 2, control and stressed rats, with or without treatment using losartan (angiotensin II type 1 receptor blocker), were evaluated using the same behavioral tests and the hypothalamus Ang II concentration was also determined. CMS increased plasma corticosterone, norepinephrine, and epinephrine concentrations, induced depression-like behaviors, impaired learning and memory, and increased the Ang II concentration in the hypothalamus. Tactile stimulation attenuated these stress-induced effects. Losartan treatment effectively prevented increase of the hypothalamic Ang II concentration and the development of depression-like behavior, and also reduced the impairment of learning and memory in the stressed animals. The results indicated that tactile stimulation seemed to protect adult rats against hormonal and behavioral chronic stress effects, and that Ang II could be involved in the CMS effects.
Publication
Journal: Genes, brain, and behavior
October/25/2019
Abstract
The CreERT2 recombinase system is an advanced method to temporally control site-specific mutagenesis in adult rodents. In this process, tamoxifen is injected to induce Cre recombinase expression, and then, Cre recombinase can excise LoxP-flanked DNA. However, tamoxifen is a non-selective estrogen receptor antagonist that may influence behavioral alterations. Therefore, we designed five different protocols (acute effects, chronic effects, chronic effects after social defeat model, chronic effects after learned helplessness model, chronic effects after isolation models) to explore whether tamoxifen affects mouse behavior. Researching the acute/ chronic effects of tamoxifen, we found that tamoxifen could influence locomotor activity, anxiety and immobility time in the forced swimming test. Researching the chronic effects of tamoxifen after social defeat/ learned helplessness/ isolation models, we found that tamoxifen could also influence locomotor activity, social interaction and anxiety. Therefore, the effects of tamoxifen are more complex than previously reported. Our results show, for the first time, that tamoxifen affects behavior in mouse models. Meanwhile, we compare the effects of tamoxifen in different protocols. These results will provide important information when designing similar experiments. inducible mutagenesis; behavior; depression; anxiety; mice; tamoxifen; psychiatry. This article is protected by copyright. All rights reserved.
Publication
Journal: Pharmaceuticals (Basel, Switzerland)
October/22/2019
Abstract
The antidepressant placebo response remains a barrier to the development of novel therapies for depression, despite decades of efforts to identify and methodologically address its clinical correlates. This manuscript reviews recent neuroimaging studies that aim to identify the neural signature of antidepressant placebo response. Data captured in clinical trials have primarily focused on antidepressant efficacy or predicting antidepressant response and have reliably implicated the rostral anterior cingulate cortex (rACC) in antidepressant placebo response, but also in medication response. Imaging and electroencephalography (EEG) experiments specifically interrogating the mechanism of antidepressant placebo response, while few, suggest the reward network, including opiate neurotransmission, is also involved. Therefore, while the rACC is likely involved in the antidepressant placebo response, its observation in isolation is unlikely to prospectively distinguish antidepressant placebo from medication responders. Instead, future studies of antidepressant placebo response should probe the reward network as a whole and incorporate sophisticated computational analytical approaches.
Publication
Journal: Substance abuse
October/22/2019
Abstract
Abstracts Background: Individuals who misuse opioids frequently have comorbid psychiatric issues, including post-traumatic stress disorder (PTSD) and depression. However, little is known about the mechanisms by which these disorders are associated with opioid misuse and specifically in community pharmacy settings. The current study examined whether depression mediated the relationship between PTSD and opioid misuse in patients filling opioid prescriptions. Methods: We administered a health survey in four community pharmacies among patients filling opioid medications in southwestern Pennsylvania. Univariate statistics were used to assess relationships among demographic and clinical characteristics of PTSD, depression, and opioid misuse behaviors. We then examined whether depression mediated the relationship between PTSD and opioid misuse using ordinary least squares path analysis with bootstrapping. Results: A total of 333 participants completed the health survey. Opioid misuse was reported among 15.9% of all participants, 33.3% among those with a positive PTSD screen, and 29.3% of those who screened positive for depression. Depression significantly mediated the relationship between PTSD and opioid misuse. Specifically, there was a statistically significant indirect effect (ab) of PTSD on opioid misuse through a pathway mediated by depression (ab = .06, SEab = .02, 95% CI = .02-.10). The direct effect (c') of PTSD on opioid misuse was also significant (c' = .12, SEc' = .05, P = .01, 95% CI = .03-.22), suggesting partial mediation. Conclusions: Results suggest an indirect pathway by which clinical intervention may help ameliorate outcomes in patients with PTSD. Further, there is an increased need for screening, assessment, and intervention protocols for this patient population in which community pharmacy is a novel setting to expand future efforts within the patient population.
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