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Journal of Affective Disorders Mar 2023The perinatal period is increasingly recognized as a vulnerable time for the development and exacerbation of psychiatric symptoms. Research has often focused on...
BACKGROUND
The perinatal period is increasingly recognized as a vulnerable time for the development and exacerbation of psychiatric symptoms. Research has often focused on perinatal depression, with much less information on perinatal anxiety. This study examined the psychometric structure of all internalizing (anxiety and mood disorder symptoms) in the perinatal period.
METHODS
Participants were primarily community adults receiving prenatal care from an academic medical center (N = 246). Participants completed a structured clinical interview using the Interview for Mood and Anxiety Symptoms (IMAS) during pregnancy (28-32 weeks gestation) and the postpartum (6-8 weeks). Clinical interviews dimensionally assessed all current anxiety, mood, and obsessive-compulsive symptoms as well as lifetime psychiatric diagnoses.
RESULTS
Confirmatory factor analyses identified three latent factors onto which psychiatric symptoms loaded: Distress (depression, generalized anxiety, irritability, and panic symptoms), Fear (social anxiety, agoraphobia, specific phobia, and obsessive-compulsive symptoms), and Bipolar (mania and obsessive-compulsive symptoms) in both pregnancy and the postpartum. The fit statistics of the models indicated adequate to good fit in both models.
LIMITATIONS
The IMAS is validated against the DSM-IV-TR rather than the DSM-5 and assessments of psychiatric symptoms were focused only on the current pregnancy.
CONCLUSIONS
A three-factor model consisting of Distress, Fear and Bipolar latent factors was the best-fitting model in pregnancy and the postpartum period and showed stability across time. The structure of internalizing symptoms has important implications for future perinatal research and can be utilized to guide treatment by highlighting which psychiatric symptoms may be most similar during the perinatal period.
Topics: Adult; Pregnancy; Female; Humans; Anxiety Disorders; Anxiety; Phobic Disorders; Mood Disorders; Depressive Disorder; Postpartum Period
PubMed: 36610596
DOI: 10.1016/j.jad.2022.12.111 -
Biological Psychiatry May 2022Obesity and mood disorders are often overlapping pathologies that are prevalent public health concerns. Many studies have indicated a positive correlation between... (Review)
Review
Obesity and mood disorders are often overlapping pathologies that are prevalent public health concerns. Many studies have indicated a positive correlation between depression and obesity, although weight loss and decreased appetite are also recognized as features of depression. Accordingly, DSM-5 defines two subtypes of depression associated with changes in feeding: melancholic depression, characterized by anhedonia and associated with decreased feeding and appetite; and atypical depression, characterized by fatigue, sleepiness, hyperphagia, and weight gain. The central nervous system plays a key role in the regulation of feeding and mood, thus suggesting that overlapping neuronal circuits may be involved in their modulation. However, these circuits have yet to be completely characterized. The central melanocortin system, a circuitry characterized by the expression of specific peptides (pro-opiomelanocortins, agouti-related protein, and neuropeptide Y) and their melanocortin receptors, has been shown to be a key player in the regulation of feeding. In addition, the melanocortin system has also been shown to affect anxiety and depressive-like behavior, thus suggesting a possible role of the melanocortin system as a biological substrate linking feeding and depression. However, more studies are needed to fully understand this complex system and its role in regulating metabolic and mood disorders. In this review, we will discuss the current literature on the role of the melanocortin system in human and animal models in feeding and mood regulation, providing evidence of the biological interplay between anxiety, major depressive disorders, appetite, and body weight regulation.
Topics: Animals; Depressive Disorder, Major; Energy Metabolism; Melanocortins; Mood Disorders; Neuropeptide Y; Obesity
PubMed: 34344535
DOI: 10.1016/j.biopsych.2021.05.026 -
Biological Psychiatry Feb 2024Knowledge of the microbiome-gut-brain axis has revolutionized the field of psychiatry. It is now well recognized that the gut bacteriome is associated with, and likely... (Review)
Review
Knowledge of the microbiome-gut-brain axis has revolutionized the field of psychiatry. It is now well recognized that the gut bacteriome is associated with, and likely influences, the pathogenesis of mental disorders, including major depressive disorder and bipolar disorder. However, while substantial advances in the field of microbiome science have been made, we have likely only scratched the surface in our understanding of how these ecosystems might contribute to mental disorder pathophysiology. Beyond the gut bacteriome, research into lesser explored components of the gut microbiome, including the gut virome, mycobiome, archaeome, and parasitome, is increasingly suggesting relevance in psychiatry. The contribution of microbiomes beyond the gut, including the oral, lung, and small intestinal microbiomes, to human health and pathology should not be overlooked. Increasing both our awareness and understanding of these less traversed fields of research are critical to improving the therapeutic benefits of treatments targeting the gut microbiome, including fecal microbiome transplantation, postbiotics and biogenics, and dietary intervention. Interdisciplinary collaborations integrating systems biology approaches are required to fully elucidate how these different microbial components and distinct microbial niches interact with each other and their human hosts. Excitingly, we may be at the start of the next microbiome revolution and thus one step closer to informing the field of precision psychiatry to improve outcomes for those living with mental illness.
Topics: Humans; Mood Disorders; Depressive Disorder, Major; Ecosystem; Gastrointestinal Microbiome; Bipolar Disorder
PubMed: 37661007
DOI: 10.1016/j.biopsych.2023.08.020 -
Molecular Psychiatry Dec 2021Major depressive disorder (MDD) is a severe, common mood disorder. While reduced cerebrospinal fluid (CSF) flow adversely affects brain metabolism and fluid balance in...
Major depressive disorder (MDD) is a severe, common mood disorder. While reduced cerebrospinal fluid (CSF) flow adversely affects brain metabolism and fluid balance in the aging population and during development, only indirect evidence links aberrant CSF circulation with many diseases including neurological, neurodegenerative, and psychiatric disorders, such as anxiety and depression. Here we show a very high concentration of p11 as a key molecular determinant for depression in ependymal cells, which is significantly decreased in patients with MDD, and in two mouse models of depression induced by chronic stress, such as restraint and social isolation. The loss of p11 in ependymal cells causes disoriented ependymal planar cell polarity (PCP), reduced CSF flow, and depression-like and anxiety-like behaviors. p11 intrinsically controls PCP core genes, which mediates CSF flow. Viral expression of p11 in ependymal cells specifically rescues the pathophysiological and behavioral deficits caused by loss of p11. Taken together, our results identify a new role and a key molecular determinant for ependymal cell-driven CSF flow in mood disorders and suggest a novel strategy for development of treatments for stress-associated neurological, neurodegenerative, and psychiatric disorders.
Topics: Aged; Animals; Anxiety Disorders; Depression; Depressive Disorder, Major; Disease Models, Animal; Humans; Mice; Neuroglia
PubMed: 34234280
DOI: 10.1038/s41380-021-01202-1 -
Journal of Traumatic Stress Aug 2023Transdiagnostic treatments have been designed to target common processes for clusters of disorders. One such treatment, transdiagnostic behavior therapy (TBT), targets...
Transdiagnostic treatments have been designed to target common processes for clusters of disorders. One such treatment, transdiagnostic behavior therapy (TBT), targets avoidance across emotional disorders, including posttraumatic stress disorder (PTSD), depressive disorders, and anxiety disorders, and has demonstrated efficacy in randomized controlled trials. The current study was designed to examine whether distinct treatment trajectories would emerge in a sample of 112 veterans receiving TBT and whether diagnostic comorbidity, baseline levels of several transdiagnostic risk factors, or treatment engagement influence trajectory membership. Growth mixture modeling revealed three distinct trajectories across depression, ds = 0.55-1.09; PTSD ds = -0.07-1.43; and panic disorder symptoms, ds = -0.13-1.09. Notably, for PTSD and panic disorder symptoms, separate classes for responders and nonresponders emerged among participants with high baseline symptom levels. Findings for the risk factors suggested that PTSD and panic nonresponders evidenced significantly higher behavioral avoidance at baseline and reduced engagement in treatment procedures and homework completion compared to responders. Together, the findings provide additional support for the use of TBT in the treatment of emotional disorders, including PTSD. Potential adaptations are discussed for patients with significantly elevated behavioral avoidance to improve treatment engagement and related outcomes.
Topics: Humans; Stress Disorders, Post-Traumatic; Behavior Therapy; Mood Disorders; Veterans; Anxiety Disorders
PubMed: 37549108
DOI: 10.1002/jts.22963 -
Neuropsychobiology 2020
Topics: Aging, Premature; Bipolar Disorder; Humans; Mood Disorders; Oxidative Stress; Psychotic Disorders
PubMed: 30991415
DOI: 10.1159/000496622 -
Genes Jul 2020Major depressive disorder (MDD) is a major health problem with significant limitations in functioning and well-being. The World Health Organization (WHO) evaluates MDD... (Review)
Review
Major depressive disorder (MDD) is a major health problem with significant limitations in functioning and well-being. The World Health Organization (WHO) evaluates MDD as one of the most disabling disorders in the world and with very high social cost. Great attention has been given to the study of the molecular mechanism underpinning MDD at the genetic, epigenetic and proteomic level. However, the importance of RNA modifications has attracted little attention until now in this field. RNA molecules are extensively and dynamically altered by a variety of mechanisms. Similar to "epigenomic" changes, which modify DNA structure or histones, RNA alterations are now termed "epitranscriptomic" changes and have been predicted to have profound consequences for gene expression and cellular functionality. Two of these modifications, adenosine to inosine (A-to-I) RNA editing and m6A methylations, have fascinated researchers over the last years, showing a new level of complexity in gene expression. In this review, we will summary the studies that focus on the role of RNA editing and m6A methylation in MDD, trying to underline their potential breakthroughs and pitfalls.
Topics: Adenosine Deaminase; Animals; Epigenome; Humans; Methyltransferases; Mood Disorders; RNA Editing
PubMed: 32752036
DOI: 10.3390/genes11080872 -
Journal of Affective Disorders Jun 2022Though the association between anxiety disorders and suicidal behavior is well-described, the impact of anxiety symptoms on suicidal thoughts and behaviors (STB) across...
BACKGROUND
Though the association between anxiety disorders and suicidal behavior is well-described, the impact of anxiety symptoms on suicidal thoughts and behaviors (STB) across different mood disorders is still unclear.
METHODS
We performed a registry-based retrospective study utilizing outcome measure data collected by the National Network of Depression Centers (NNDC), a nationwide nonprofit consortium of 26 leading clinical and academic member centers in the United States. The sample consisted of 2607 outpatients with mood disorders (major depressive disorder or bipolar disorders). Demographic and clinical variables were compared based on the presence or absence of STB and severity of anxiety symptoms (minimal, mild, moderate, and severe). Univariate and multivariable logistic regressions were conducted to examine the correlations of STB, considering multicollinearity.
RESULTS
Patients with mild, moderate, and severe anxiety symptoms had higher odds of STB than those with minimal symptoms. Gender, marital status, age, and depressive symptoms were other strong predictors of STB. There was no difference in the odds of STB between patients with major depressive disorder (MDD) and those with bipolar disorders (BD). However, the odds of suicidal ideation were slightly lower among patients with BD than those with MDD.
LIMITATIONS
Our sample was comprised only of outpatients, limiting the generalization of our findings. Other limitations include the lack of structured interviews for diagnostic characterization of the patients and the utilization of data on anxiety and mood obtained solely through self-report scales.
CONCLUSIONS
We found a cross-sectional association between the severity of anxiety symptoms and STB among patients with mood disorders. This study demonstrates the need for a suicide risk assessment in patients with mood disorders reporting anxiety symptoms.
Topics: Anxiety; Cross-Sectional Studies; Depressive Disorder, Major; Humans; Mood Disorders; Retrospective Studies; Risk Factors; Suicidal Ideation
PubMed: 35331824
DOI: 10.1016/j.jad.2022.03.046 -
Journal of Endocrinological... Nov 2021The close association among thyroid metabolism, mood disorders and behavior has long been known. The old and modern uses of thyroid hormones to modulate the expression... (Review)
Review
PURPOSE
The close association among thyroid metabolism, mood disorders and behavior has long been known. The old and modern uses of thyroid hormones to modulate the expression of depression and bipolar disorder and to improve clinical outcome when used in conjunction with psychotropic medications.
METHODS
A literature search was performed to identify studies investigating the effects of thyroid hormone treatment in patient s with mood disorders.
RESULTS
The successful modification of mood disorders with thyroid hormone underscores the association between endocrine and cerebral systems in these disorders. Thyroid hormones have a profound influence on behavior and appear to be capable of modulating the phenotypic expression of major mood disorders. In fact, there is evidence that triiodothyronine (LT3) may accelerate the antidepressant response to antidepressants, and studies suggest that LT3 also may augment the response to antidepressants in refractory depression. Add-on treatment with supraphysiologic doses of levothyroxine (LT4) has shown efficacy in open-label and in placebo-controlled studies, including in rapid cycling and prophylaxis-resistant bipolar disorder, and with acute refractory uni- or bipolar depression. Functional brain-imaging studies (PET) demonstrated that administration of supraphysiologic LT4 improves depressive symptoms in patients with bipolar depression by modulating cerebral activity in the anterior limbic network.
CONCLUSION
The add-on administration of supraphysiologic doses of LT4 is a promising strategy in patients with refractory bipolar and depressive mood disorders.
Topics: Antidepressive Agents; Bipolar Disorder; Depressive Disorder; Drug Interactions; Humans; Thyroid Diseases; Thyroid Hormones; Thyroxine
PubMed: 34129186
DOI: 10.1007/s40618-021-01600-w -
The European Journal of Neuroscience May 2022Regulation of emotions is generally associated exclusively with the brain. However, there is evidence that peripheral systems are also involved in mood, stress... (Review)
Review
Regulation of emotions is generally associated exclusively with the brain. However, there is evidence that peripheral systems are also involved in mood, stress vulnerability vs. resilience, and emotion-related memory encoding. Prevalence of stress and mood disorders such as major depression, bipolar disorder, and post-traumatic stress disorder is increasing in our modern societies. Unfortunately, 30%-50% of individuals respond poorly to currently available treatments highlighting the need to further investigate emotion-related biology to gain mechanistic insights that could lead to innovative therapies. Here, we provide an overview of inflammation-related mechanisms involved in mood regulation and stress responses discovered using animal models. If clinical studies are available, we discuss translational value of these findings including limitations. Neuroimmune mechanisms of depression and maladaptive stress responses have been receiving increasing attention, and thus, the first part is centered on inflammation and dysregulation of brain and circulating cytokines in stress and mood disorders. Next, recent studies supporting a role for inflammation-driven leakiness of the blood-brain and gut barriers in emotion regulation and mood are highlighted. Stress-induced exacerbated inflammation fragilizes these barriers which become hyperpermeable through loss of integrity and altered biology. At the gut level, this could be associated with dysbiosis, an imbalance in microbial communities, and alteration of the gut-brain axis which is central to production of mood-related neurotransmitter serotonin. Novel therapeutic approaches such as anti-inflammatory drugs, the fast-acting antidepressant ketamine, and probiotics could directly act on the mechanisms described here improving mood disorder-associated symptomatology. Discovery of biomarkers has been a challenging quest in psychiatry, and we end by listing promising targets worth further investigation.
Topics: Animals; Antidepressive Agents; Bipolar Disorder; Brain; Inflammation; Mood Disorders
PubMed: 33876886
DOI: 10.1111/ejn.15239