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World Journal of Gastroenterology Jan 2016The hypothesis of an important role of gut microbiota in the maintenance of physiological state into the gastrointestinal (GI) system is supported by several studies... (Review)
Review
The hypothesis of an important role of gut microbiota in the maintenance of physiological state into the gastrointestinal (GI) system is supported by several studies that have shown a qualitative and quantitative alteration of the intestinal flora in a number of gastrointestinal and extra-gastrointestinal diseases. In the last few years, the importance of gut microbiota impairment in the etiopathogenesis of pathology such as autism, dementia and mood disorder, has been raised. The evidence of the inflammatory state alteration, highlighted in disorders such as schizophrenia, major depressive disorder and bipolar disorder, strongly recalls the microbiota alteration, highly suggesting an important role of the alteration of GI system also in neuropsychiatric disorders. Up to now, available evidences display that the impairment of gut microbiota plays a key role in the development of autism and mood disorders. The application of therapeutic modulators of gut microbiota to autism and mood disorders has been experienced only in experimental settings to date, with few but promising results. A deeper assessment of the role of gut microbiota in the development of autism spectrum disorder (ASD), as well as the advancement of the therapeutic armamentarium for the modulation of gut microbiota is warranted for a better management of ASD and mood disorders.
Topics: Animals; Anti-Bacterial Agents; Autism Spectrum Disorder; Autistic Disorder; Fecal Microbiota Transplantation; Gastrointestinal Microbiome; Humans; Mood Disorders; Probiotics
PubMed: 26755882
DOI: 10.3748/wjg.v22.i1.361 -
Psychopharmacology Feb 2021Major depressive disorder is one of the leading global causes of disability, for which the classic serotonergic psychedelics have recently reemerged as a potential... (Meta-Analysis)
Meta-Analysis Review
RATIONALE
Major depressive disorder is one of the leading global causes of disability, for which the classic serotonergic psychedelics have recently reemerged as a potential therapeutic treatment option.
OBJECTIVE
We present the first meta-analytic review evaluating the clinical effects of classic serotonergic psychedelics vs placebo for mood state and symptoms of depression in both healthy and clinical populations (separately).
RESULTS
Our search revealed 12 eligible studies (n = 257; 124 healthy participants, and 133 patients with mood disorders), with data from randomized controlled trials involving psilocybin (n = 8), lysergic acid diethylamide ([LSD]; n = 3), and ayahuasca (n = 1). The meta-analyses of acute mood outcomes (3 h to 1 day after treatment) for healthy volunteers and patients revealed improvements with moderate significant effect sizes in favor of psychedelics, as well as for the longer-term (16 to 60 days after treatments) mood state of patients. For patients with mood disorder, significant effect sizes were detected on the acute, medium (2-7 days after treatment), and longer-term outcomes favoring psychedelics on the reduction of depressive symptoms.
CONCLUSION
Despite the concerns over unblinding and expectancy, the strength of the effect sizes, fast onset, and enduring therapeutic effects of these psychotherapeutic agents encourage further double-blind, placebo-controlled clinical trials assessing them for management of negative mood and depressive symptoms.
Topics: Affect; Banisteriopsis; Depression; Depressive Disorder, Major; Double-Blind Method; Hallucinogens; Healthy Volunteers; Humans; Lysergic Acid Diethylamide; Mood Disorders; Psilocybin; Randomized Controlled Trials as Topic; Serotonin Receptor Agonists; Treatment Outcome
PubMed: 33427944
DOI: 10.1007/s00213-020-05719-1 -
Health Promotion and Chronic Disease... May 2017We are pleased to bring you the second of two special issues on mood and anxiety disorders focussing on data from the 2014 Survey on Living with Chronic Diseases in...
We are pleased to bring you the second of two special issues on mood and anxiety disorders focussing on data from the 2014 Survey on Living with Chronic Diseases in Canada-Mood and Anxiety Disorder Component (SLCDC-MA). In December of 2016, we published the first issue, which included three articles describing various aspects of Canadian adults with a self-reported diagnosed mood and/or anxiety disorder including their sociodemographic characteristics, health status, activity limitations and level of disability and factors associated with well-being. The three articles in this (second) issue investigate topics related to the management of these disorders. Collectively, the articles explore key sociodemographic factors known to influence health-related outcomes and discuss strategies aimed at promoting the recovery and well-being of Canadian adults with a self-reported mood and/or anxiety disorder diagnosis.
Topics: Anxiety Disorders; Canada; Health Surveys; Humans; Mood Disorders; Periodicals as Topic
PubMed: 28493657
DOI: 10.24095/hpcdp.37.5.01 -
JAMA Psychiatry Jan 2024Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD) because of overlapping symptoms and the lack of objective diagnostic tools.
IMPORTANCE
Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD) because of overlapping symptoms and the lack of objective diagnostic tools.
OBJECTIVE
To identify a reproducible metabolomic biomarker signature in patient dried blood spots (DBSs) that differentiates BD from MDD during depressive episodes and assess its added value when combined with self-reported patient information.
DESIGN, SETTING, AND PARTICIPANTS
This diagnostic analysis used samples and data from the Delta study, conducted in the UK between April 27, 2018, and February 6, 2020. The primary objective was to identify BD in patients with a recent (within the past 5 years) diagnosis of MDD and current depressive symptoms (Patient Health Questionnaire-9 score of 5 or more). Participants were recruited online through voluntary response sampling. The analysis was carried out between February 2022 and July 2023.
MAIN OUTCOMES AND MEASURES
Patient data were collected using a purpose-built online questionnaire (n = 635 questions). DBS metabolites (n = 630) were analyzed using a targeted mass spectrometry-based platform. Mood disorder diagnoses were established using the Composite International Diagnostic Interview.
RESULTS
Of 241 patients in the discovery cohort, 170 (70.5%) were female; 67 (27.8%) were subsequently diagnosed with BD and 174 (72.2%) were confirmed as having MDD; and the mean (SD) age was 28.1 (7.1) years. Of 30 participants in the validation cohort, 16 (53%) were female; 9 (30%) were diagnosed with BD and 21 (70%) with MDD; and the mean (SD) age was 25.4 (6.3) years. DBS metabolite levels were assessed in 241 patients with depressive symptoms with a recent diagnosis of MDD, of whom 67 were subsequently diagnosed with BD by the Composite International Diagnostic Interview and 174 were confirmed as having MDD. The identified 17-biomarker panel provided a mean (SD) cross-validated area under the receiver operating characteristic curve (AUROC) of 0.71 (SD, 0.12; P < .001), with ceramide d18:0/24:1 emerging as the strongest biomarker. Combining biomarker data with patient-reported information significantly enhanced diagnostic performance of models based on extensive demographic data, PHQ-9 scores, and the outcomes from the Mood Disorder Questionnaire. The identified biomarkers were correlated primarily with lifetime manic symptoms and were validated in a separate group of patients who received a new clinical diagnosis of MDD (n = 21) or BD (n = 9) during the study's 1-year follow-up period, with a mean (SD) AUROC of 0.73 (0.06; P < .001).
CONCLUSIONS AND RELEVANCE
This study provides a proof of concept for developing an accessible biomarker test to facilitate the differential diagnosis of BD and MDD and highlights the potential involvement of ceramides in the pathophysiological mechanisms of mood disorders.
Topics: Humans; Female; Adult; Male; Bipolar Disorder; Depressive Disorder, Major; Mood Disorders; Diagnosis, Differential; Biomarkers
PubMed: 37878349
DOI: 10.1001/jamapsychiatry.2023.4096 -
The Lancet. Psychiatry Jun 2018Disruption of sleep and circadian rhythmicity is a core feature of mood disorders and might be associated with increased susceptibility to such disorders. Previous...
Association of disrupted circadian rhythmicity with mood disorders, subjective wellbeing, and cognitive function: a cross-sectional study of 91 105 participants from the UK Biobank.
BACKGROUND
Disruption of sleep and circadian rhythmicity is a core feature of mood disorders and might be associated with increased susceptibility to such disorders. Previous studies in this area have used subjective reports of activity and sleep patterns, but the availability of accelerometer-based data from UK Biobank participants permits the derivation and analysis of new, objectively ascertained circadian rhythmicity parameters. We examined associations between objectively assessed circadian rhythmicity and mental health and wellbeing phenotypes, including lifetime history of mood disorder.
METHODS
UK residents aged 37-73 years were recruited into the UK Biobank general population cohort from 2006 to 2010. We used data from a subset of participants whose activity levels were recorded by wearing a wrist-worn accelerometer for 7 days. From these data, we derived a circadian relative amplitude variable, which is a measure of the extent to which circadian rhythmicity of rest-activity cycles is disrupted. In the same sample, we examined cross-sectional associations between low relative amplitude and mood disorder, wellbeing, and cognitive variables using a series of regression models. Our final model adjusted for age and season at the time that accelerometry started, sex, ethnic origin, Townsend deprivation score, smoking status, alcohol intake, educational attainment, overall mean acceleration recorded by accelerometry, body-mass index, and a binary measure of childhood trauma.
FINDINGS
We included 91 105 participants with accelerometery data collected between 2013 and 2015 in our analyses. A one-quintile reduction in relative amplitude was associated with increased risk of lifetime major depressive disorder (odds ratio [OR] 1·06, 95% CI 1·04-1·08) and lifetime bipolar disorder (1·11, 1·03-1·20), as well as with greater mood instability (1·02, 1·01-1·04), higher neuroticism scores (incident rate ratio 1·01, 1·01-1·02), more subjective loneliness (OR 1·09, 1·07-1·11), lower happiness (0·91, 0·90-0·93), lower health satisfaction (0·90, 0·89-0·91), and slower reaction times (linear regression coefficient 1·75, 1·05-2·45). These associations were independent of demographic, lifestyle, education, and overall activity confounders.
INTERPRETATION
Circadian disruption is reliably associated with various adverse mental health and wellbeing outcomes, including major depressive disorder and bipolar disorder. Lower relative amplitude might be linked to increased susceptibility to mood disorders.
FUNDING
Lister Institute of Preventive Medicine.
Topics: Accelerometry; Biological Specimen Banks; Circadian Rhythm; Cognition; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Mood Disorders; Sleep; United Kingdom
PubMed: 29776774
DOI: 10.1016/S2215-0366(18)30139-1 -
Child and Adolescent Psychiatric... Jan 2021This article reviews the literature on mood disorders and sleep disorders among children and adolescents. Research suggests that sleep plays an important role in the... (Review)
Review
This article reviews the literature on mood disorders and sleep disorders among children and adolescents. Research suggests that sleep plays an important role in the development, progression, and maintenance of mood disorder symptoms among children and adolescents. Sleep problems as early as maternal perinatal insomnia may predict and predate depression among youth. Children and adolescents who develop comorbid mood disorders and sleep problems represent a particularly high-risk group with more severe mood episode symptoms, higher rates of self-harm and suicidality, and less responsivity to treatment. Treatment research supports the idea that sleep problems can be improved through behavioral interventions.
Topics: Adolescent; Child; Female; Humans; Mood Disorders; Pregnancy; Sleep; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders
PubMed: 33223065
DOI: 10.1016/j.chc.2020.09.003 -
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 -
Advances in Neurobiology 2021Stroke is the leading cause of human death and disability. After a stroke, many patients may have some physical disability, including difficulties in moving, speaking,... (Review)
Review
Stroke is the leading cause of human death and disability. After a stroke, many patients may have some physical disability, including difficulties in moving, speaking, and seeing, but patients may also exhibit changes in mood manifested by depression, anxiety, and cognitive changes which we call post-stroke mood disorders (PSMDs). Astrocytes are the most diverse and numerous glial cell type in the central nervous system (CNS). They provide structural, nutritional, and metabolic support to neurons and regulate synaptic activity under normal conditions. Astrocytes are also critically involved in focal ischemic stroke (FIS). They undergo many changes after FIS. These changes may affect acute neuronal death and brain damage as well as brain recovery and PSMD in the chronic phase after FIS. Studies using postmortem brain specimens and animal models of FIS suggest that astrocytes/reactive astrocytes are involved in PSMD. This chapter provides an overview of recent advances in the molecular base of astrocyte in PSMD. As astrocytes exhibit high plasticity after FIS, we suggest that targeting local astrocytes may be a promising strategy for PSMD therapy.
Topics: Animals; Astrocytes; Brain Ischemia; Humans; Mood Disorders; Neurons; Stroke
PubMed: 34888833
DOI: 10.1007/978-3-030-77375-5_6 -
Psychiatria Polska 2015This paper looks at some recent developments in the official diagnostic definitions (DSM-5) and in the research domain. The spectrum concept of mood disorders consists... (Review)
Review
This paper looks at some recent developments in the official diagnostic definitions (DSM-5) and in the research domain. The spectrum concept of mood disorders consists of the components of depression and mania, alone or in combination, on a continuum. Its international operational classification changes regularly, being based on symptoms, their duration and consequences. Causation is as yet unknown. DSM-5 excludes unipolar mania and mania with mild depression as separate diagnoses (they come under bipolar I and bipolar II disorders) and introduces a new hierarchy of manic symptoms, placing energy/activity above mood (elated, irritable). This is shown to be problematic on the basis of recent data. The validity of the duration criteria for mania (1 week), hypomania (4 days) and depression (2 weeks) is also seriously questioned. Shorter episodes are clinically very relevant. The definition of mania/hypomania is a persistent problem, contributing to frequent un- derdiagnosis of bipolar disorder in depressed patients. Other contributory factors include that patients often do not feel ill or seek treatment for the consequences of their high mood, and that hypomania can be hidden by substance use disorders (SUD). Hidden hypomanic syndromes are important because associated with treatment resistance, high comorbidity with anxiety/panic and SUD, psychotic and cognitive symptoms, dementia and higher mortality. Anxiety, too, is doubtless a mood disorder but there is still no concept which integrates anxiety with bipolar disorder and depression.
Topics: Behavioral Symptoms; Bipolar Disorder; Diagnostic Errors; Diagnostic and Statistical Manual of Mental Disorders; Humans; Medical History Taking; Prevalence
PubMed: 26488343
DOI: 10.12740/PP/58259 -
Psychiatria Polska Apr 2017Genetic research in Psychiatry is viewed by clinicians with both hope and curiosity sometimes mixed with disillusionment. Indeed, in the last 30 years many results have... (Review)
Review
Genetic research in Psychiatry is viewed by clinicians with both hope and curiosity sometimes mixed with disillusionment. Indeed, in the last 30 years many results have not been confirmed and clinical applications are still missing. However recent findings suggest that we are at the beginning of a new era. A set of variants within neuroplasticity and inflammation genes have been identified as a valid basis for both bipolar disorder and major depression. Similarly, a set of genes has been identified as a liability factor for response and tolerability to antidepressants and the first clinical applications are already in the market. However, some caution should be applied until definite findings are available.
Topics: Affect; Antidepressive Agents; Depressive Disorder; Humans; Mood Disorders; Pharmacogenetics; Research Design; Secondary Prevention; Treatment Outcome
PubMed: 28581531
DOI: 10.12740/PP/68914