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Jie S, Fu A, Wang C, Rajabi S. A comprehensive review on the impact of polyphenol supplementation and exercise on depression and brain function parameters. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2025; 21:10. [PMID: 40140839 PMCID: PMC11948876 DOI: 10.1186/s12993-025-00273-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Accepted: 03/14/2025] [Indexed: 03/28/2025]
Abstract
The objective of this review study is to examine the combined antidepressant effects of exercise and polyphenol supplementation, with a focus on specific polyphenolic compounds such as crocin, curcumin, and quercetin, as well as different forms of physical exercise, including aerobic and resistance training. The research examines how these interventions influence depressive-like behaviors, cognitive function, and neurochemical markers in animal models and human participants. The findings demonstrate that both exercise and polyphenols independently contribute to mood enhancement, reduced anxiety, and improved cognitive function through mechanisms such as neurogenesis, neurotransmitter modulation, and anti-inflammatory effects. Notably, the combined interventions showed a synergistic effect, providing more significant benefits in reducing symptoms of depression and anxiety, enhancing cognitive performance, and supporting overall mental well-being. These results suggest that integrating exercise and polyphenol supplementation could be a promising non-pharmacological approach to managing depression and related disorders.
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Affiliation(s)
- Shihong Jie
- Institute of Physical Education, Woosuk University, Jeollabuk-do, 55338, Korea
| | - Aili Fu
- Physical Education and Research Section, Basic Teaching Department, Guangdong Maoming Health Vocational College, Maoming, Guangdong, 525400, China
| | - Chuan Wang
- Physical Education Teaching and Research Office, Dalian University of Foreign Languages, Dalian, Liaoning, 116044, China.
| | - Sogand Rajabi
- Department of Cellular and Molecular Biology, Islamic Azad University, Sirjan Branch, Iran.
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Liang X, Ding Y, Zhu X, Qiu J, Shen X, Xiong Y, Zhou J, Liang X, Xie W. Suprachiasmatic nucleus dysfunction induces anxiety- and depression-like behaviors via activating the BDNF-TrkB pathway of the striatum. Transl Psychiatry 2025; 15:92. [PMID: 40118822 PMCID: PMC11928668 DOI: 10.1038/s41398-025-03313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 02/18/2025] [Accepted: 03/11/2025] [Indexed: 03/24/2025] Open
Abstract
The circadian rhythm system consists of a master clock located in the suprachiasmatic nucleus (SCN) of the hypothalamus and peripheral clocks dispersed throughout other brain areas (including striatum, Str) as well as various tissues and organs. Circadian rhythm disturbance is a major risk factor and common comorbidity for mood disorders, especially anxiety and depression. Bmal1 is one of the fundamental clock protein genes that is required to maintain circadian rhythm. Recent research has revealed a link between suprachiasmatic nucleus dysfunction and anxiety and depression, but the underlying mechanisms remain to be fully elucidated. This study aimed to investigate how circadian rhythm disturbance may lead to anxiety- and depression-like behaviors. Through behavioral tests, virus tracing, molecular biology and other techniques, we found neural connection from the suprachiasmatic nucleus to the striatum. SCN lesions and Bmal1flox/flox + pAAV-hSyn-Cre-GFP (conditional knockout, cKO) mice exhibited disruptions in core body temperature rhythm, as well as anxiety- and depression-like behaviors. Importantly, these mice displayed altered expression patterns of clock protein genes and an upregulation of the Brain-Derived Neurotrophic Factor (BDNF) - Tyrosine Kinase receptor B (TrkB) signaling pathway within the striatum. Microinjection of the TrkB inhibitor ANA-12 can effectively reverse anxiety- and depression-like behaviors. These findings indicate that suprachiasmatic nucleus dysfunction may contribute to the pathogenesis of anxiety and depression through upregulation of the BDNF-TrkB pathway in the striatum, potentially mediated by neural projections from the SCN. Bmal1 gene within SCN may represent a novel therapeutic target for mood disorders.
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Affiliation(s)
- Xiaotao Liang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, P.R. China
- Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, P.R. China
| | - Yuewen Ding
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, P.R. China
- Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, P.R. China
| | - Xiaoyu Zhu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, P.R. China
| | - Jing Qiu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, P.R. China
| | - Xiaoqin Shen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, P.R. China
| | - Yifan Xiong
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, P.R. China
| | - Jieli Zhou
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, P.R. China
| | - Xiaoshan Liang
- Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, P.R. China.
| | - Wei Xie
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, P.R. China.
- Guangdong Basic Research Center of Excellence for Integrated Traditional and Western Medicine for Qingzhi Diseases, Guangzhou, 510515, P.R. China.
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3
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Duan J, Zhang Y, Tao J, Fan X. Prevalence and Correlates of Diurnal Mood Variation in Chinese Adolescents with Major Depressive Disorder and Anxiety Symptoms: A Cross-Sectional Study. Neuropsychiatr Dis Treat 2025; 21:347-353. [PMID: 40007745 PMCID: PMC11853055 DOI: 10.2147/ndt.s484456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 01/20/2025] [Indexed: 02/27/2025] Open
Abstract
Purpose Diurnal mood variation is one of the prominent symptoms in depression. However, little is known about this phenomenon. This study examined diurnal variation in adolescents with comorbid depression and anxiety symptoms, and assessed the incidence, correlates, and related factors. Patients and Methods The study comprised a sample of 557 outpatients who were adolescents suffering from anxiety and depression. Symptom severity was assessed using the Zung Self-Rating Depression Scale, Anxiety Scale, and 24-item Hamilton Rating Scale for Depression. Results Majority of the participants (69.83%) reported diurnal mood variation throughout the day. Higher score on the Zung Self-Rating Depression Scale, specifically somatic, cognitive impairment, retardation, sleep disturbance, and feelings of despair, were noted in individuals with diurnal variation compared to those without. Additionally, there was a significant correlation between feelings of despair and diurnal mood variation, which was able to predict diurnal variation in adolescent aged 10 to 13 years or those whose depressive symptoms were mild. Conclusion Diurnal mood variation is common in adolescents with major depressive disorder and anxiety. The pattern is associated with more severe depressive symptoms. Feelings of despair are a potential associated factor for diurnal changes in mood, although the discriminatory capacity of this variable is limited.
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Affiliation(s)
- Jiawen Duan
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Yijing Zhang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Jingyi Tao
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Xiwang Fan
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, People’s Republic of China
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Rahim AR, Will V, Myung J. Mood variation under dual regulation of circadian clock and light. Chronobiol Int 2025; 42:162-184. [PMID: 39840618 DOI: 10.1080/07420528.2025.2455144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2024] [Revised: 12/16/2024] [Accepted: 01/09/2025] [Indexed: 01/23/2025]
Abstract
The intricate relationship between circadian rhythms and mood is well-established. Disturbances in circadian rhythms and sleep often precede the development of mood disorders, such as major depressive disorder (MDD), bipolar disorder (BD), and seasonal affective disorder (SAD). Two primary factors, intrinsic circadian clocks and light, drive the natural fluctuations in mood throughout the day, mirroring the patterns of sleepiness and wakefulness. Nearly all organisms possess intrinsic circadian clocks that coordinate daily rhythms, with light serving as the primary environmental cue to synchronize these internal timekeepers with the 24-hour cycle. Additionally, light directly influences mood states. Disruptions to circadian rhythms, such as those caused by jet lag, shift work, or reduced daylight hours, can trigger or exacerbate mood symptoms. The complex and often subtle connections between circadian disruptions and mood dysregulation suggest that focusing solely on individual clock genes is insufficient to fully understand their etiology and progression. Instead, mood instability may arise from systemic misalignments between external cycles and the internal synchronization of circadian clocks. Here, we synthesize past research on the independent contributions of circadian clocks and light to mood regulation, drawing particularly on insights from animal studies that illuminate fundamental mechanisms relevant to human health.
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Affiliation(s)
- Amalia Ridla Rahim
- Laboratory of Braintime, Graduate Institute of Mind, Brain and Consciousness (GIMBC), Taipei Medical University, Taipei, Taiwan
| | - Veronica Will
- Laboratory of Braintime, Graduate Institute of Mind, Brain and Consciousness (GIMBC), Taipei Medical University, Taipei, Taiwan
| | - Jihwan Myung
- Laboratory of Braintime, Graduate Institute of Mind, Brain and Consciousness (GIMBC), Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Medical Sciences (GIMS), Taipei Medical University, Taipei, Taiwan
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5
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Sarzetto A, Cavallini MC, Pacchioni F, Casoni F, Attanasio F, Fregna L, Strambi LF, Colombo C. Duration of major depressive episodes and sleep architecture: an exploratory study. J Psychiatr Res 2025; 181:596-598. [PMID: 39740614 DOI: 10.1016/j.jpsychires.2024.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 06/28/2024] [Accepted: 12/21/2024] [Indexed: 01/02/2025]
Abstract
Growing evidence supports sleep-wake disruption as a mechanism involved in mood disorders pathogenesis. Duration of depressive episodes varies widely, and longer depressive episodes have been connected to worse outcomes. We aimed to explore if the length of depressive episodes is related to objective modifications of sleep features. 35 subjects, aged 18-70, hospitalized for the treatment of a major depressive episode, either unipolar or bipolar, underwent polysomnography, upon admittance. Objective sleep features were correlated with the length of the ongoing depressive episode, measured in months. Positive correlations were found between the duration of the depressive episode and wake percentage (r = 0.358, p = 0.035), N3 latency (r = 0.451, p = 0.014) and wake after sleep onset (r = 0.342, p = 0,44). Our findings show that individuals suffering longer depressive episodes can experience objectively worse sleep features, in terms of increased night wakefulness and delayed deep sleep.
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Affiliation(s)
| | - Maria Cristina Cavallini
- Department of Clinical Neuroscience, Mood Disorders Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Francesca Casoni
- Department of Clinical Neuroscience, Sleep Disorders Centre, IRCCS San Raffaele Scientific Institute, Italy
| | | | - Lorenzo Fregna
- Department of Clinical Neuroscience, Mood Disorders Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Luigi Ferini Strambi
- Department of Clinical Neuroscience, Sleep Disorders Centre, IRCCS San Raffaele Scientific Institute, Italy
| | - Cristina Colombo
- Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neuroscience, Mood Disorders Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Allen O, Coombes BJ, Pazdernik V, Gisabella B, Hartley J, Biernacka JM, Frye MA, Markota M, Pantazopoulos H. Differential serum levels of CACNA1C, circadian rhythm and stress response molecules in subjects with bipolar disorder: Associations with genetic and clinical factors. J Affect Disord 2024; 367:148-156. [PMID: 39233237 PMCID: PMC11496001 DOI: 10.1016/j.jad.2024.08.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/23/2024] [Accepted: 08/31/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Many patients with bipolar disorder (BD) do not respond to or have difficulties tolerating lithium and/or other mood stabilizing agents. There is a need for personalized treatments based on biomarkers in guiding treatment options. The calcium voltage-gated channel CACNA1C is a promising candidate for developing personalized treatments. CACNA1C is implicated in BD by genome-wide association studies and several lines of evidence suggest that targeting L-type calcium channels could be an effective treatment strategy. However, before such individualized treatments can be pursued, biomarkers predicting treatment response need to be developed. METHODS As a first step in testing the hypothesis that CACNA1C genotype is associated with serum levels of CACNA1C, we conducted ELISA measures on serum samples from 100 subjects with BD and 100 control subjects. RESULTS We observed significantly higher CACNA1C (p < 0.01) protein levels in subjects with BD. The risk single nucleotide polymorpshism (SNP) (rs11062170) showed functional significance as subjects homozygous for the risk allele (CC) had significantly greater CACNA1C protein levels compared to subjects with one (p = 0.013) or no copies (p = 0.009). We observed higher somatostatin (SST) (p < 0.003) protein levels and lower levels of the clock protein aryl hydrocarbon receptor nuclear translocator-like (ARTNL) (p < 0.03) and stress signaling factor corticotrophin releasing hormone (CRH) (p < 0.001) in BD. SST and period 2 (PER2) protein levels were associated with both alcohol dependence and lithium response. CONCLUSIONS Our findings represent the first evidence for increased serum levels of CACNA1C in BD. Along with altered levels of SST, ARNTL, and CRH our findings suggest CACNA1C is associated with circadian rhythm and stress response disturbances in BD.
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Affiliation(s)
- Obie Allen
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Brandon J Coombes
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Vanessa Pazdernik
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Barbara Gisabella
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA; Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS, USA
| | - Joshua Hartley
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Joanna M Biernacka
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Matej Markota
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Harry Pantazopoulos
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA; Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS, USA.
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7
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Yan R, Chaku N, Lopez-Duran NL, Deldin PJ, Beltz AM. Gender matters for daily depression: Symptom fluctuations and links to self-expression. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2024; 18:100839. [PMID: 39640866 PMCID: PMC11619048 DOI: 10.1016/j.jadr.2024.100839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2024] Open
Abstract
Background Depression is a global health burden, disproportionately affecting women. A lack of contextual, real-life assessments considering the oft-gendered context (e.g., expression) of daily symptom fluctuations may contribute to this disparity. The current study examines: a) gender differences in daily depressive symptoms - and fluctuations; and b) daily links between self-perceived gender expression and depressive symptoms. Methods Established adults (N = 96; M age = 28.19, SD age = 8.43) participated in an ecologically-valid multi-wave 100-day intensive longitudinal study. They reported daily on their depressive symptoms, and on their self-expression in the final study wave. Gender differences in daily symptoms fluctuations (intraindividual standard deviations) and their links to gender expression (person-specific residualized correlations) were examined. Results Women experienced greater day-to-day symptom fluctuations than men, after accounting for the gender difference in baseline symptoms (b = -0.05; 95 % CI: [-0.093, -0.012]). Results from a subsample (n = 28) showed that daily links between gender expression and depressive symptoms were heterogeneous: For 38.5 % of men and 53.3 % of women, daily increases in congruent gender expressions (i.e., masculine for men and feminine for women) corresponded with daily symptom decreases, but many individuals (46.4 %) did not show meaningful relations. Conclusions Results highlight the utility of intensive longitudinal approaches for the study of depression and, for some people, the daily psychological relations with gender self-perceptions. Results also emphasize heterogeneity in depression etiology and the need for personalized basic and applied science. Limitations Future research on individuals with varying gender identities and clinical experiences is needed.
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Affiliation(s)
- Ran Yan
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109-1043, United States
| | - Natasha Chaku
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109-1043, United States
- Department of Psychological and Brain Sciences, Indiana University Bloomington, 1101 East 10th Street, Bloomington, IN 47405-7007, United States
| | - Nestor L. Lopez-Duran
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109-1043, United States
| | - Patricia J. Deldin
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109-1043, United States
| | - Adriene M. Beltz
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109-1043, United States
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Klusmann H, Brose A, Schulze L, Engel S, Laufer S, Bücklein E, Knaevelsrud C, Schumacher S. Menstrual cycle related depressive symptoms and their diurnal fluctuations - an ambulatory assessment study. BMC Womens Health 2024; 24:611. [PMID: 39551735 PMCID: PMC11572536 DOI: 10.1186/s12905-024-03438-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 11/02/2024] [Indexed: 11/19/2024] Open
Abstract
BACKGROUND Reproductive mood disorders indicate that within-person variation in depressive symptoms across the menstrual cycle can be related to ovarian hormone changes. Until now, such cycle-related symptom changes have been measured once daily, even though depression research indicates systematic diurnal changes in symptoms. Further, previous research often focused on aggregated depression scores. This study examined whether three daily assessments of depressive symptoms follow similar trajectories across the menstrual cycle and investigated within-person cyclical fluctuation of all individual symptoms and the aggregated score. METHODS 77 naturally-cycling participants (35 with and 42 without depressive disorder) provided three daily ratings of depressive symptoms across one menstrual cycle to evaluate individual and summarized symptoms. RESULTS Reliability estimates (w) of the three diurnal measurements ranged from 0.56 to 0.78. Cyclicity showed statistically significant interindividual differences for all symptoms, and individual symptoms differed significantly from each other in their magnitude of cyclicity. LIMITATIONS Only one menstrual cycle was assessed to reduce participant burden. Further, ovulation testing dates were based on self-reported cycle lengths, and only LH (luteinizing hormone) peaks were tested without subsequent progesterone rises. CONCLUSIONS The results highlight the need for a symptom-specific approach to assess individual variance in cyclicity of depressive symptoms. Reliability for one daily assessment can be improved by using the afternoon value, a sum score for depressiveness, or multiple items per symptom. Furthermore, this study emphasizes, that depressive symptoms can systematically change across the menstrual cycle, and it is, therefore, important to include it in depression research. Exploring female-specific risk factors of depression will enable the development of person-tailored treatments. TRIAL REGISTRATION The study was preregistered at ClinicalTrials.gov (NCT04086316) with the first registration on 27/08/2019.
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Affiliation(s)
- Hannah Klusmann
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Schwendenerstraße 27, Berlin, 14195, Germany.
| | - Annette Brose
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Schwendenerstraße 27, Berlin, 14195, Germany
| | - Lars Schulze
- Division of Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany
| | - Sinha Engel
- Department of Experimental Psychopathology, Institute for Psychology, University of Hildesheim, Hildesheim, Germany
| | - Sebastian Laufer
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Schwendenerstraße 27, Berlin, 14195, Germany
- Clinical Psychology and Psychotherapy, Institute for Mental Health and Behavioral Medicine, HMU Health and Medical University, Olympischer Weg 1, Potsdam, 14471, Germany
| | - Elise Bücklein
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Calwerstr. 14, Tübingen, 72076, Germany
| | - Christine Knaevelsrud
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Schwendenerstraße 27, Berlin, 14195, Germany
| | - Sarah Schumacher
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Schwendenerstraße 27, Berlin, 14195, Germany
- Clinical Psychology and Psychotherapy, Institute for Mental Health and Behavioral Medicine, HMU Health and Medical University, Olympischer Weg 1, Potsdam, 14471, Germany
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Druiven SJM, Hovenkamp-Hermelink JHM, Kamphuis J, Haarman BCM, Meesters Y, Riese H, Schoevers RA. Circadian markers as a predictor of response in the treatment of depression-A systematic review. Psychiatry Res 2024; 338:115976. [PMID: 38830322 DOI: 10.1016/j.psychres.2024.115976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 04/29/2024] [Accepted: 05/23/2024] [Indexed: 06/05/2024]
Abstract
Despite many available treatment options for depression, response rates remain suboptimal. To improve outcome, circadian markers may be suitable as markers of treatment response. This systematic review provides an overview of circadian markers that have been studied as predictors of response in treatment of depression. A search was performed (EMBASE, PUBMED, PSYCHINFO) for research studies or articles, randomized controlled trials and case report/series with no time boundaries on March 2, 2024 (PROSPERO: CRD42021252333). Other criteria were; an antidepressant treatment as intervention, treatment response measured by depression symptom severity and/or occurrence of a clinical diagnosis of depression and assessment of a circadian marker at baseline. 44 articles, encompassing 8,772 participants were included in the analysis. Although additional research is needed with less variation in types of markers and treatments to provide definitive recommendations, circadian markers, especially diurnal mood variation and chronotype, show potential to implement as response markers in the clinic.
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Affiliation(s)
- S J M Druiven
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands.
| | - J H M Hovenkamp-Hermelink
- Department of Practice-Oriented Scientific Research (PWO), Alliade Care Group, Heerenveen, the Netherlands
| | - J Kamphuis
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - B C M Haarman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Y Meesters
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - H Riese
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - R A Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
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10
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Tamm J, Takano K, Just L, Ehring T, Rosenkranz T, Kopf-Beck J. Ecological Momentary Assessment versus Weekly Questionnaire Assessment of Change in Depression. Depress Anxiety 2024; 2024:9191823. [PMID: 40226649 PMCID: PMC11919112 DOI: 10.1155/2024/9191823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 04/15/2025] Open
Abstract
Objective Ecological momentary assessment (EMA) is increasingly used to monitor depressive symptoms in clinical trials, but little is known about the comparability of its outcomes to those of clinical interviews and questionnaires. In our study, we administered EMA and questionnaires to measure change in depressive symptoms and repetitive negative thinking (RNT) in a clinical trial and investigated (a) the size of intervention effects associated with both techniques and (b) their validity in predicting clinical interview outcomes (i.e., global functioning). Materials and Methods Seventy-one depressed patients were randomly assigned to one of three psychological interventions. The EMA comprised a concise item set (four items per scale) and was administered three times per day during a 7-week intervention period. Conversely, questionnaires were assessed weekly (WQA), encompassing their full sets of items of depressive symptoms and RNT. Results While EMA excelled in detecting significant intervention effects, WQA demonstrated greater strength in predicting clinician ratings of global functioning. Additionally, we observed significant differences in time effects (slopes) between the two techniques. WQA scores decreased steeper over time and were more extreme, e.g., higher at baseline and lower postintervention, than EMA scores. Conclusions Although clinical interviews, questionnaires, and EMA outcomes are related, they assess changes in depression differently. EMA may be more sensitive to intervention effects, but all three methods harbor potential bias, raising validity and reliability questions. Therefore, to enhance the validity and reliability of clinical trial assessments, we emphasize the importance of EMA approaches that combine subjective self-reports with objectively measured behavioral markers. This trial is registered with osf.io/9fuhn.
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Affiliation(s)
- Jeanette Tamm
- Max-Planck-Institute of Psychiatry, Munich, Germany
- Department of Psychology, LMU Munich, Munich, Germany
| | - Keisuke Takano
- Department of Psychology, LMU Munich, Munich, Germany
- Human Informatics and Interaction Research Institute (HIIRI), National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Leah Just
- Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munich, Germany
- DZPG (German Center for Mental Health), Munich, Germany
| | | | - Johannes Kopf-Beck
- Max-Planck-Institute of Psychiatry, Munich, Germany
- Department of Psychology, LMU Munich, Munich, Germany
- DZPG (German Center for Mental Health), Munich, Germany
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11
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Nexha A, Pilz LK, Oliveira MAB, Xavier NB, Borges RB, Frey BN, Hidalgo MPL. Greater within- and between-day instability is associated with worse anxiety and depression symptoms. J Affect Disord 2024; 356:215-223. [PMID: 38582128 DOI: 10.1016/j.jad.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/07/2024] [Accepted: 04/03/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Depression and anxiety affect hundreds of millions of people worldwide, and their prevalence increased during the COVID-19 pandemic as social schedules were disrupted. This study explores the associations between anxiety and depression and within- and between-day instability of affective, somatic, and cognitive symptoms during the early pandemic stages. METHODS Participants (n = 153, ages 18-77, 72 % female) reported daily levels of affective (anxiety/sadness), somatic (appetite/sleepiness), and cognitive (concentration/energy) symptoms for 14-44 days at five timepoints: 0, 3, 6, 9, and 12 h after awakening. At the end of the study, participants completed validated scales for anxiety (GAD-7) and depression (PHQ-9). Symptom instability was assessed using the Absolute Real Variability (ARV) index. Regression models examined within-day instability (WD-I) and between-day instability (BD-I) with GAD-7 and PHQ-9 scores as outcomes. RESULTS Greater instability (both WD-I and BD-I) of affective symptoms correlated with elevated GAD-7 and PHQ-9 scores. For somatic and cognitive symptoms, greater BD-I was associated with higher scores. LIMITATIONS The study used retrospective daily data, which could benefit from real-time assessments for improved accuracy. CONCLUSIONS This study provides empirical evidence of a connection between greater anxiety and depression severity and increased instability in daily mood and physiological symptoms. The findings underscore the importance of consistent symptom monitoring to understand overall mental health trajectories. Additionally, it highlights the role of daily routines in stabilizing the circadian system, potentially regulating physiological and psychological processes and reducing symptom instability.
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Affiliation(s)
- Adile Nexha
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.
| | - Luísa K Pilz
- Graduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Anesthesiology and Intensive Care Medicine CCM/CVK, Charité - Universitätsmedizin Berlin, Berlin, Germany; ECRC Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Melissa A B Oliveira
- Graduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Nicoli B Xavier
- Graduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Rogério Boff Borges
- Biostatistics Unit - Research Board (DIPE), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Statistics, Institute of Mathematics and Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada; Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Maria Paz L Hidalgo
- Graduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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12
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Allen O, Coombes BJ, Pazdernik V, Gisabella B, Hartley J, Biernacka JM, Frye MA, Markota M, Pantazopoulos H. Differential Serum Levels of CACNA1C, Circadian Rhythm and Stress Response Molecules in Subjects with Bipolar Disorder: Associations with Genetic and Clinical Factors. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.11.24305678. [PMID: 38645236 PMCID: PMC11030295 DOI: 10.1101/2024.04.11.24305678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Background Many patients with bipolar disorder (BD) do not respond to or have difficulties tolerating lithium and/or other mood stabilizing agents. There is a need for personalized treatments based on biomarkers in guiding treatment options. The calcium voltage-gated channel CACNA1C is a promising candidate for developing personalized treatments. CACNA1C is implicated in BD by genome-wide association studies and several lines of evidence suggest that targeting L-type calcium channels could be an effective treatment strategy. However, before such individualized treatments can be pursued, biomarkers predicting treatment response need to be developed. Methods As a first step in testing the hypothesis that CACNA1C genotype is associated with serum levels of CACNA1C, we conducted ELISA measures on serum samples from 100 subjects with BD and 100 control subjects. Results We observed significantly higher CACNA1C (p<0.01) protein levels in subjects with BD. The risk SNP (rs11062170) showed functional significance as subjects homozygous for the risk allele (CC) had significantly greater CACNA1C protein levels compared to subjects with one (p=0.013) or no copies (p=0.009). We observed higher somatostatin (SST) (p<0.003) protein levels and lower levels of the clock protein ARTNL (p<0.03) and stress signaling factor corticotrophin releasing hormone (CRH) (p<0.001) in BD. SST and PER2 protein levels were associated with both alcohol dependence and lithium response. Conclusions Our findings represent the first evidence for increased serum levels of CACNA1C in BD. Along with altered levels of SST, ARNTL, and CRH our findings suggest CACNA1C is associated with circadian rhythm and stress response disturbances in BD.
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Affiliation(s)
- Obie Allen
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Brandon J. Coombes
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Vanessa Pazdernik
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Barbara Gisabella
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
- Program in Neuroscience, University of Mississippi Medical Center, Jackson, Mississippi
| | - Joshua Hartley
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Joanna M. Biernacka
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Mark A. Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Matej Markota
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Harry Pantazopoulos
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
- Program in Neuroscience, University of Mississippi Medical Center, Jackson, Mississippi
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13
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Tokioka S, Nakaya N, Nakaya K, Kogure M, Hatanaka R, Chiba I, Kanno I, Nochioka K, Metoki H, Murakami T, Satoh M, Nakamura T, Ishikuro M, Obara T, Hamanaka Y, Orui M, Kobayashi T, Uruno A, Kodama EN, Nagaie S, Ogishima S, Izumi Y, Fuse N, Kuriyama S, Hozawa A. The association between depressive symptoms and masked hypertension in participants with normotension measured at research center. Hypertens Res 2024; 47:586-597. [PMID: 37907602 PMCID: PMC10912033 DOI: 10.1038/s41440-023-01484-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/28/2023] [Accepted: 10/06/2023] [Indexed: 11/02/2023]
Abstract
Masked hypertension is a risk factor for cardiovascular diseases. However, masked hypertension is sometimes overlooked owing to the requirement for home blood pressure measurements for diagnosing. Mental status influences blood pressure. To reduce undiagnosed masked hypertension, this study assessed the association between depressive symptoms and masked hypertension. This cross-sectional study used data from the Tohoku Medical Megabank Project Community-Based Cohort Study (conducted in Miyagi Prefecture, Japan, from 2013) and included participants with normotension measured at the research center (systolic blood pressure<140 mmHg and diastolic blood pressure <90 mmHg). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (Japanese version). Masked hypertension was defined as normotension measured at the research center and home hypertension (home systolic blood pressure ≥135 mmHg or home diastolic blood pressure ≥85 mmHg). The study comprised 6705 participants (mean age: 55.7 ± 13.7 years). Of these participants, 1106 (22.1%) without depressive symptoms and 393 (23.2%) with depressive symptoms were categorized to have masked hypertension. Sex-specific and age-adjusted least mean squares for home blood pressure, not for research blood pressure were significantly higher in the group with depressive symptoms in both sex categories. The multivariate odds ratio for masked hypertension in the patients with depressive symptoms was 1.72 (95% confidence interval: 1.26-2.34) in male participants and 1.30 (95% confidence interval: 1.06-1.59) in female ones. Depressive symptoms were associated with masked hypertension in individuals with normotension measured at the research center. Depressive symptoms may be one of the risk factors for masked hypertension. Depressive symptoms were associated with masked hypertension in individuals with normotension measured at research center.
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Affiliation(s)
- Sayuri Tokioka
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kumi Nakaya
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Mana Kogure
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Rieko Hatanaka
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Ippei Chiba
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Ikumi Kanno
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kotaro Nochioka
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takahisa Murakami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Michihiro Satoh
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Tomohiro Nakamura
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Kyoto Women's University, Kyoto, Japan
| | - Mami Ishikuro
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Taku Obara
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Yohei Hamanaka
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Masatsugu Orui
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Tomoko Kobayashi
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Akira Uruno
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Eiichi N Kodama
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Satoshi Nagaie
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Soichi Ogishima
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Yoko Izumi
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Nobuo Fuse
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Shinichi Kuriyama
- Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Tohoku University Graduate School of Medicine, Sendai, Japan.
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
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14
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Guo S, Zhu W, Yu L, Jie L, Tian D, Zhao T, Zhao B, Zhang B. The potential causal relationship between various lifestyles and depression: a univariable and multivariable Mendelian randomization study. Front Psychiatry 2024; 15:1343132. [PMID: 38487581 PMCID: PMC10937522 DOI: 10.3389/fpsyt.2024.1343132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
Background Previous studies have shown that lifestyle was associated with depression. Thus, the aim of this study was to examine the causality between multiple lifestyles and depression by Mendelian randomization (MR) analysis. Methods The single-nucleotide polymorphisms (SNPs) of depression, alcoholic drinks per week, sleeplessness or insomnia, body mass index (BMI), mood swings, weekly usage of mobile phone in the last 3 months, beef intake, cooked vegetable intake, and "smoking status: never" were acquired from the Integrative Epidemiology Unit Open genome-wide association study database. Causal effects of eight exposure factors and depression were investigated using MR-Egger, weighted median, inverse variance weighted (IVW), simple mode, and weighted mode, and results were primarily referred to IVW. Subsequently, univariable MR (UVMR) analysis was performed on eight exposure factors and depression, separately. In addition, sensitivity analysis, including heterogeneity test, horizontal pleiotropy, and leave-one-out (LOO) methods, was conducted to evaluate the stability of MR results. Furthermore, multivariable MR (MVMR) analysis was carried out. Results UVMR analysis revealed that all eight exposure factors were causally associated with depression; alcoholic drinks per week, sleeplessness or insomnia, BMI, mood swings, weekly usage of mobile phone in the last 3 months, and cooked vegetable intake were risk factors, and beef intake and "smoking status: never" were protection factors. Heterogeneity tests revealed no heterogeneity for alcoholic drinks per week, sleeplessness or insomnia, mood swings, weekly usage of mobile phone in the last 3 months, and cooked vegetable intake. Meanwhile, there was no horizontal pleiotropy in UVMR, and LOO analysis verified that univariable analysis results were reliable. Moreover, MVMR analysis indicated that mood swings and weekly usage of mobile phone in the last 3 months were risk factors, and beef intake was a protection factor for depression when multiple factors occurred at the same time. Conclusion Alcoholic drinks per week, sleeplessness or insomnia, BMI, mood swings, weekly usage of mobile phone in the last 3 months, and cooked vegetable intake were risk factors, and beef intake and "smoking status: never" were protection factors. In addition, mood swings, weekly usage of mobile phone in the last 3 months, and beef intake had a direct effect on depression when multiple factors occurred simultaneously.
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Affiliation(s)
- Shaobo Guo
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Geriatrics, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Hospital of Chinese Medicine, Department of Geriatrics, Nanjing, China
| | - Wenhui Zhu
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Geriatrics, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Hospital of Chinese Medicine, Department of Geriatrics, Nanjing, China
| | - Likai Yu
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Geriatrics, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Hospital of Chinese Medicine, Department of Geriatrics, Nanjing, China
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, China
| | - Lishi Jie
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Geriatrics, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Hospital of Chinese Medicine, Department of Geriatrics, Nanjing, China
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, China
| | - Di Tian
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Geriatrics, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Hospital of Chinese Medicine, Department of Geriatrics, Nanjing, China
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, China
| | - Tianci Zhao
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Geriatrics, Nanjing, China
- Jiangsu Province Hospital of Chinese Medicine, Department of Geriatrics, Nanjing, China
| | - Biqing Zhao
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Geriatrics, Nanjing, China
- Jiangsu Province Hospital of Chinese Medicine, Department of Geriatrics, Nanjing, China
| | - Biao Zhang
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Geriatrics, Nanjing, China
- Jiangsu Province Hospital of Chinese Medicine, Department of Geriatrics, Nanjing, China
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15
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Scheer FAJL, Chellappa SL. Endogenous circadian rhythms in mood and well-being. Sleep Health 2024; 10:S149-S153. [PMID: 37648646 DOI: 10.1016/j.sleh.2023.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/16/2023] [Accepted: 07/21/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES We examined whether the endogenous circadian timing system modulates proxies of mood vulnerability and well-being. METHODS Nineteen healthy participants (mean age: 26.6 years [23.0-30.2], seven females, body-mass index: 22.8 kg/m2 [21.1-25]) completed a laboratory protocol with a 32-hour Constant Routine, a stringently controlled protocol designed to isolate assessment of endogenous circadian rhythms. We assessed hourly anxiety- and depression-like mood (i.e., those typically observed in depression and anxiety) and well-being (i.e., associated with mental fatigue and physical comfort). RESULTS Significant endogenous circadian rhythms were observed in anxiety-like and depression-like mood, as well as well-being (p values from the mixed-model analysis using false discovery rates < .001). Post-hoc comparisons revealed more anxiety-like and depression-like mood during the circadian phase 60°-75° (∼8-9 a.m.), and more mental fatigue and less physical comfort during the circadian phase 30°-60° (∼6-8 a.m.). CONCLUSIONS Our data indicate endogenous circadian rhythms in anxiety-like and depression-like mood and well-being in healthy young adults. Future studies will help establish circadian-based therapeutics for individuals experiencing mood and anxiety disorders.
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Affiliation(s)
- Frank A J L Scheer
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
| | - Sarah L Chellappa
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, U.K..
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16
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Dollish HK, Tsyglakova M, McClung CA. Circadian rhythms and mood disorders: Time to see the light. Neuron 2024; 112:25-40. [PMID: 37858331 PMCID: PMC10842077 DOI: 10.1016/j.neuron.2023.09.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/09/2023] [Accepted: 09/20/2023] [Indexed: 10/21/2023]
Abstract
The importance of time is ever prevalent in our world, and disruptions to the normal light/dark and sleep/wake cycle have now become the norm rather than the exception for a large part of it. All mood disorders, including seasonal affective disorder (SAD), major depressive disorder (MDD), and bipolar disorder (BD), are strongly associated with abnormal sleep and circadian rhythms in a variety of physiological processes. Environmental disruptions to normal sleep/wake patterns, light/dark changes, and seasonal changes can precipitate episodes. Moreover, treatments that target the circadian system have proven to be therapeutic in certain cases. This review will summarize much of our current knowledge of how these disorders associate with specific circadian phenotypes, as well as the neuronal mechanisms that link the circadian clock with mood regulation. We also discuss what has been learned from therapies that target circadian rhythms and how we may use current knowledge to develop more individually designed treatments.
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Affiliation(s)
- Hannah K Dollish
- Department of Psychiatry, University of Pittsburgh School of Medicine, 450 Technology Drive, Suite 223, Pittsburgh, PA 15219, USA
| | - Mariya Tsyglakova
- Department of Psychiatry, University of Pittsburgh School of Medicine, 450 Technology Drive, Suite 223, Pittsburgh, PA 15219, USA
| | - Colleen A McClung
- Department of Psychiatry, University of Pittsburgh School of Medicine, 450 Technology Drive, Suite 223, Pittsburgh, PA 15219, USA.
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17
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Shapiro B, Fang Y, Sen S, Forger D. Unraveling the interplay of circadian rhythm and sleep deprivation on mood: A Real-World Study on first-year physicians. PLOS DIGITAL HEALTH 2024; 3:e0000439. [PMID: 38295082 PMCID: PMC10829990 DOI: 10.1371/journal.pdig.0000439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 12/25/2023] [Indexed: 02/02/2024]
Abstract
The interplay between circadian rhythms, time awake, and mood remains poorly understood in the real-world. Individuals in high-stress occupations with irregular schedules or nighttime shifts are particularly vulnerable to depression and other mood disorders. Advances in wearable technology have provided the opportunity to study these interactions outside of a controlled laboratory environment. Here, we examine the effects of circadian rhythms and time awake on mood in first-year physicians using wearables. Continuous heart rate, step count, sleep data, and daily mood scores were collected from 2,602 medical interns across 168,311 days of Fitbit data. Circadian time and time awake were extracted from minute-by-minute wearable heart rate and motion measurements. Linear mixed modeling determined the relationship between mood, circadian rhythm, and time awake. In this cohort, mood was modulated by circadian timekeeping (p<0.001). Furthermore, we show that increasing time awake both deteriorates mood (p<0.001) and amplifies mood's circadian rhythm nonlinearly. These findings demonstrate the contributions of both circadian rhythms and sleep deprivation to underlying mood and show how these factors can be studied in real-world settings using Fitbits. They underscore the promising opportunity to harness wearables in deploying chronotherapies for psychiatric illness.
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Affiliation(s)
- Benjamin Shapiro
- Department of Psychiatry, Dartmouth Health, Hanover, New Hampshire, United States of America
- Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, United States of America
| | - Yu Fang
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Srijan Sen
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Daniel Forger
- Department of Mathematics, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, United States of America
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18
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Goldschmied JR, Boland E, Palermo E, Barilla H, Dinges DF, Detre JA, Basner M, Sheline YI, Rao H, Gehrman P. Antidepressant effects of acute sleep deprivation are reduced in highly controlled environments. J Affect Disord 2023; 340:412-419. [PMID: 37553017 PMCID: PMC10528033 DOI: 10.1016/j.jad.2023.07.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Numerous studies summarized in a recent meta-analysis have shown sleep deprivation rapidly improves depressive symptoms in approximately 50 % of individuals with major depressive disorder (MDD), however those studies were typically conducted in clinical settings. Here we investigated the effects of sleep deprivation utilizing a highly controlled experimental approach. METHODS 36 antidepressant-free individuals with MDD and 10 healthy controls (HC) completed a 5 day/4-night protocol consisting of adaptation, baseline, total sleep deprivation (TSD), and recovery phases. Light was kept consistently dim (≤50 lx), meals were regulated, and activity was restricted. In-the-moment mood was assessed using a modified Hamilton Rating Scale for Depression (HRSD) at screening and each morning following the experimental nights. RESULTS Day of study had a significant effect on mood in both groups. Post-hoc analyses revealed that significant effects were attributed to mood improvement in the MDD group following study initiation prior to beginning TSD, and in the HC group following recovery sleep, but were not due to mood improvement in the MDD group during TSD. No further improvement in mood occurred during 36 h of TSD. LIMITATIONS Strict eligibility requirements may limit generalizability. The requirement to be medication free may have biased toward a less severely depressed sample. CONCLUSIONS Results revealed that individuals with moderate MDD can experience a significant reduction in depressive symptoms upon entering a highly controlled laboratory environment. Environmental effects on mood can be substantial and need to be considered.
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Affiliation(s)
- Jennifer R Goldschmied
- Department of Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104, United States.
| | - Elaine Boland
- Department of Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104, United States; Behavioral Health Service, Cpl. Michael J. Crescenz VA Medical Center, 3900 Woodland Ave., Philadelphia, PA 19104, United States.
| | - Emma Palermo
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, United States.
| | - Holly Barilla
- Department of Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104, United States.
| | - David F Dinges
- Department of Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104, United States.
| | - John A Detre
- Department of Neurology, University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, United States.
| | - Mathias Basner
- Department of Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104, United States.
| | - Yvette I Sheline
- Department of Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104, United States.
| | - Hengyi Rao
- Department of Neurology, University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, United States.
| | - Philip Gehrman
- Department of Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104, United States; Behavioral Health Service, Cpl. Michael J. Crescenz VA Medical Center, 3900 Woodland Ave., Philadelphia, PA 19104, United States.
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Borisenkov MF, Tserne TA, Popov SV, Smirnov VV, Dorogina OI, Pecherkina AA, Symaniuk EE. Association of Chrononutrition Indices with Anthropometric Parameters, Academic Performance, and Psychoemotional State of Adolescents: A Cross-Sectional Study. Nutrients 2023; 15:4521. [PMID: 37960174 PMCID: PMC10647400 DOI: 10.3390/nu15214521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Adolescents are an at-risk group for circadian misalignment. The contribution of sleep-wake rhythm instability to the psychoemotional, cognitive, and weight disorders of adolescents has been studied in sufficient detail. At the same time, there is insufficient information about the association between chrononutrition indices and the well-being of adolescents. The aim of this study is to investigate the relationship between chrononutrition indices and academic achievement, psychoemotional state, and anthropometric indicators in adolescents. The study involved 12,759 students in grades 6-11 of secondary schools, aged 14.2 ± 1.7 years old; 57.2% of whom were girls. Participants provided personal data, frequency and time of meals during the day and at night, on weekdays and weekends, and completed the Zung Self-Rating Depression Scale and the Yale Food Addiction Scale. There is a U-shaped association between eating mid-phase (EPFc), eating jetlag (EJL), and eating window (EW) with GPA, ZSDSI, and FA. At the same time, the frequency of night eating (NE) is linearly associated with the studied parameters. NE is the strongest predictor of ZSDSI (β = 0.24), FA (β = 0.04), and GPA (β = -0.22). EPFc, EJL, and EW practically do not differ in the strength of their association with the studied indicators. ZSDSI is most closely associated with the chrononutrition indices. There is a weak negative association between BMI and EW (β = -0.03) and NE (β = -0.04). Thus, circadian eating disorders are more often observed in adolescents with poor academic performance, high levels of depression, and food addiction.
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Affiliation(s)
- Mikhail F. Borisenkov
- Department of Molecular Immunology and Biotechnology, Institute of Physiology of Federal Research Centre “Komi Science Centre of the Urals Branch of the Russian Academy of Sciences”, 167982 Syktyvkar, Russia; (T.A.T.); (S.V.P.); (V.V.S.)
| | - Tatyana A. Tserne
- Department of Molecular Immunology and Biotechnology, Institute of Physiology of Federal Research Centre “Komi Science Centre of the Urals Branch of the Russian Academy of Sciences”, 167982 Syktyvkar, Russia; (T.A.T.); (S.V.P.); (V.V.S.)
| | - Sergey V. Popov
- Department of Molecular Immunology and Biotechnology, Institute of Physiology of Federal Research Centre “Komi Science Centre of the Urals Branch of the Russian Academy of Sciences”, 167982 Syktyvkar, Russia; (T.A.T.); (S.V.P.); (V.V.S.)
| | - Vasily V. Smirnov
- Department of Molecular Immunology and Biotechnology, Institute of Physiology of Federal Research Centre “Komi Science Centre of the Urals Branch of the Russian Academy of Sciences”, 167982 Syktyvkar, Russia; (T.A.T.); (S.V.P.); (V.V.S.)
| | - Olga I. Dorogina
- Ural Institute of Humanities, Ural Federal University, 620000 Yekaterinburg, Russia; (O.I.D.); (E.E.S.)
| | - Anna A. Pecherkina
- Ural Institute of Humanities, Ural Federal University, 620000 Yekaterinburg, Russia; (O.I.D.); (E.E.S.)
| | - Elvira E. Symaniuk
- Ural Institute of Humanities, Ural Federal University, 620000 Yekaterinburg, Russia; (O.I.D.); (E.E.S.)
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20
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de Leeuw M, Verhoeve SI, van der Wee NJA, van Hemert AM, Vreugdenhil E, Coomans CP. The role of the circadian system in the etiology of depression. Neurosci Biobehav Rev 2023; 153:105383. [PMID: 37678570 DOI: 10.1016/j.neubiorev.2023.105383] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/19/2023] [Accepted: 09/02/2023] [Indexed: 09/09/2023]
Abstract
Circadian rhythms have evolved in almost all organisms enabling them to anticipate alternating changes in the environment. As a consequence, the circadian clock controls a broad range of bodily functions including appetite, sleep, activity and cortisol levels. The circadian clock synchronizes itself to the external world mainly by environmental light cues and can be disturbed by a variety of factors, including shift-work, jet-lag, stress, ageing and artificial light at night. Interestingly, mood has also been shown to follow a diurnal rhythm. Moreover, circadian disruption has been associated with various mood disorders and patients suffering from depression have irregular biological rhythms in sleep, appetite, activity and cortisol levels suggesting that circadian rhythmicity is crucially involved in the etiology and pathophysiology of depression. The aim of the present review is to give an overview and discuss recent findings in both humans and rodents linking a disturbed circadian rhythm to depression. Understanding the relation between a disturbed circadian rhythm and the etiology of depression may lead to novel therapeutic and preventative strategies.
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Affiliation(s)
- Max de Leeuw
- Department of Psychiatry, Leiden University Medical Center, Postal Zone B1-P, P.O. Box 9600, Leiden 2300 RC, the Netherlands; Mental Health Care Rivierduinen, Bipolar Disorder Outpatient Clinic, PO Box 405, Leiden 2300 AK, the Netherlands.
| | - Sanne I Verhoeve
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, the Netherlands
| | - Nic J A van der Wee
- Department of Psychiatry, Leiden University Medical Center, Postal Zone B1-P, P.O. Box 9600, Leiden 2300 RC, the Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Postal Zone B1-P, P.O. Box 9600, Leiden 2300 RC, the Netherlands
| | - Erno Vreugdenhil
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, the Netherlands
| | - Claudia P Coomans
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, the Netherlands
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21
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Wiłkość-Dębczyńska M, Liberacka-Dwojak M. Time of day and chronotype in the assessment of cognitive functions. POSTEPY PSYCHIATRII NEUROLOGII 2023; 32:162-166. [PMID: 38034504 PMCID: PMC10683050 DOI: 10.5114/ppn.2023.132032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/02/2023] [Indexed: 12/02/2023]
Abstract
Purpose Circadian rhythms are synchronized, through the endogenous biological clock, with the 24-hour cycle, and associated with numerous changes in human functioning, both in physical and mental aspects. It is assumed that daily fluctuations in cognitive performance are a consequence of interacting homeostatic and circadian processes regulating an individual's sleep-wake rhythms. A chronotype may be understood as a phenotype of circadian cycles determined by an endogenous biological clock. Despite research findings showing a significant relationship between those factors and cognition, they remain insufficiently considered in the domain of cognitive psychology and neuropsychology. Views This narrative review aims to describe and highlight the interactions between the time of day, chronotype, and cognitive performance in domains of mental activity variables, receptive functions, memory and learning, expressive functions, and thinking. Conclusions The results of the research show that time-of-day effects on basic and more complex cognitive functions depend on an individual's chronotype with a dominant effect of synchrony between chronotype and time of cognitive testing, with large differences in circadian cycles between younger and older age groups. It is suggested that chronotype assessment and time of day control should be included as important variables in the diagnosis of cognitive function in both healthy and clinical populations. There is also an emerging need for further investigations to better understand how chronotype and circadian rhythms modulate human brain physiology and cognition.
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Oh JW, Kim SM, Lee D, Son NH, Uh J, Yoon JH, Choi Y, Lee S. Evaluating the Modified Patient Health Questionnaire-2 and Insomnia Severity Index-2 for Daily Digital Screening of Depression and Insomnia: Validation Study. JMIR Ment Health 2023; 10:e45543. [PMID: 37213186 DOI: 10.2196/45543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/30/2023] [Accepted: 04/11/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND The Patient Health Questionnaire-2 (PHQ-2) and Insomnia Severity Index-2 (ISI-2) are screening assessments that reflect the past 2-week experience of depression and insomnia, respectively. Retrospective assessment has been associated with reduced accuracy owing to recall bias. OBJECTIVE This study aimed to increase the reliability of responses by validating the use of the PHQ-2 and ISI-2 for daily screening. METHODS A total of 167 outpatients from the psychiatric department at the Yongin Severance Hospital participated in this study, of which 63 (37.7%) were male and 104 (62.3%) were female with a mean age of 35.1 (SD 12.1) years. Participants used a mobile app ("Mental Protector") for 4 weeks and rated their depressive and insomnia symptoms daily on the modified PHQ-2 and ISI-2 scales. The validation assessments were conducted in 2 blocks, each with a fortnight response from the participants. The modified version of the PHQ-2 was evaluated against the conventional scales of the Patient Health Questionnaire-9 and the Korean version of the Center for Epidemiologic Studies Depression Scale-Revised. RESULTS According to the sensitivity and specificity analyses, an average score of 3.29 on the modified PHQ-2 was considered valid for screening for depressive symptoms. Similarly, the ISI-2 was evaluated against the conventional scale, Insomnia Severity Index, and a mean score of 3.50 was determined to be a valid threshold for insomnia symptoms when rated daily. CONCLUSIONS This study is one of the first to propose a daily digital screening measure for depression and insomnia delivered through a mobile app. The modified PHQ-2 and ISI-2 were strong candidates for daily screening of depression and insomnia, respectively.
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Affiliation(s)
- Jae Won Oh
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Sun Mi Kim
- Department of Nursing, Andong Science College, Andong, Republic of Korea
| | - Deokjong Lee
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Nak-Hoon Son
- Department of Statistics, Keimyung University, Daegu, Republic of Korea
| | - Jinsun Uh
- Mobigen Co, Ltd, Seongnam, Republic of Korea
| | - Ju Hong Yoon
- Korea Electronics Technology Institute, Seongnam, Republic of Korea
| | - Yukyung Choi
- Department of Intelligent Mechatronics Engineering, Sejong University, Seoul, Republic of Korea
| | - San Lee
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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23
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Kober KM, Roy R, Conley Y, Dhruva A, Hammer MJ, Levine J, Olshen A, Miaskowski C. Prediction of morning fatigue severity in outpatients receiving chemotherapy: less may still be more. Support Care Cancer 2023; 31:253. [PMID: 37039882 DOI: 10.1007/s00520-023-07723-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 04/01/2023] [Indexed: 04/12/2023]
Abstract
INTRODUCTION Fatigue is the most common and debilitating symptom experienced by cancer patients undergoing chemotherapy (CTX). Prediction of symptom severity can assist clinicians to identify high-risk patients and provide education to decrease symptom severity. The purpose of this study was to predict the severity of morning fatigue in the week following the administration of CTX. METHODS Outpatients (n = 1217) completed questionnaires 1 week prior to and 1 week following administration of CTX. Morning fatigue was measured using the Lee Fatigue Scale (LFS). Separate prediction models for morning fatigue severity were created using 157 demographic, clinical, symptom, and psychosocial adjustment characteristics and either morning fatigue scores or individual fatigue item scores. Prediction models were created using two regression and five machine learning approaches. RESULTS Elastic net models provided the best fit across all models. For the EN model using individual LFS item scores, two of the 13 individual LFS items (i.e., "worn out," "exhausted") were the strongest predictors. CONCLUSIONS This study is the first to use machine learning techniques to accurately predict the severity of morning fatigue from prior to through the week following the administration of CTX using total and individual item scores from the Lee Fatigue Scale (LFS). Our findings suggest that the language used to assess clinical fatigue in oncology patients is important and that two simple questions may be used to predict morning fatigue severity.
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Affiliation(s)
- Kord M Kober
- School of Nursing, University of California, San Francisco, CA, USA.
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
- Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA.
| | - Ritu Roy
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Yvette Conley
- School of Nursing, University of Pittsburg, Pittsburg, PA, USA
| | - Anand Dhruva
- School of Medicine, University of California, San Francisco, CA, USA
| | | | - Jon Levine
- School of Medicine, University of California, San Francisco, CA, USA
| | - Adam Olshen
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
- Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA
- School of Medicine, University of California, San Francisco, CA, USA
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
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24
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Makhoul M, Bartley EJ. Exploring the relationship between gratitude and depression among older adults with chronic low back pain: a sequential mediation analysis. FRONTIERS IN PAIN RESEARCH 2023; 4:1140778. [PMID: 37213708 PMCID: PMC10196463 DOI: 10.3389/fpain.2023.1140778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/14/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction Gratitude has been identified as a key factor in a number of positive health-related outcomes; however, the mechanisms whereby gratitude is associated with well-being among older adults with chronic pain are poorly understood. Using the Positive Psychological Well-Being Model as a theoretical framework, the objective of the present study was to examine the serial mediating effects of social support, stress, sleep, and tumor necrosis factor-alpha (TNF-α) on the relationship between gratitude and depressive symptoms. Methods A total sample of 60 community-dwelling older adults with chronic low back pain (cLBP) provided blood samples for high-sensitivity TNF-α and completed the Gratitude Questionnaire, Perceived Stress Scale, and the PROMIS Emotional Support, Sleep Disturbance, and Depression forms. Descriptive statistics, correlation analyses, and serial mediation analyses were performed. Results Gratitude was negatively associated with perceived stress, sleep disturbance, and depression, and was positively associated with social support. No significant association was observed between gratitude and TNF-α. After controlling for age and marital status, analyses revealed that perceived stress and sleep disturbance sequentially mediated the association between gratitude and depressive symptoms. Conclusion Perceived stress and sleep disturbance may be potential mechanistic pathways by which gratitude impacts negative well-being. Targeting gratitude as a protective resource may be a potential therapeutic tool to improve psychological and behavioral outcomes in older adults with cLBP.
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Affiliation(s)
- Melissa Makhoul
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - E. J. Bartley
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
- Correspondence: E. J. Bartley
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25
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Gumus M, DeSouza DD, Xu M, Fidalgo C, Simpson W, Robin J. Evaluating the utility of daily speech assessments for monitoring depression symptoms. Digit Health 2023; 9:20552076231180523. [PMID: 37426590 PMCID: PMC10328009 DOI: 10.1177/20552076231180523] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 05/19/2023] [Indexed: 07/11/2023] Open
Abstract
Objective Depression is a common mental health disorder and a major public health concern, significantly interfering with the lives of those affected. The complex clinical presentation of depression complicates symptom assessments. Day-to-day fluctuations of depression symptoms within an individual bring an additional barrier, since infrequent testing may not reveal symptom fluctuation. Digital measures such as speech can facilitate daily objective symptom evaluation. Here, we evaluated the effectiveness of daily speech assessment in characterizing speech fluctuations in the context of depression symptoms, which can be completed remotely, at a low cost and with relatively low administrative resources. Methods Community volunteers (N = 16) completed a daily speech assessment, using the Winterlight Speech App, and Patient Health Questionnaire-9 (PHQ-9) for 30 consecutive business days. We calculated 230 acoustic and 290 linguistic features from individual's speech and investigated their relationship to depression symptoms at the intra-individual level through repeated measures analyses. Results We observed that depression symptoms were linked to linguistic features, such as less frequent use of dominant and positive words. Greater depression symptomatology was also significantly correlated with acoustic features: reduced variability in speech intensity and increased jitter. Conclusions Our findings support the feasibility of using acoustic and linguistic features as a measure of depression symptoms and propose daily speech assessment as a tool for better characterization of symptom fluctuations.
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Affiliation(s)
- Melisa Gumus
- Winterlight Labs, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | | | - Mengdan Xu
- Winterlight Labs, Toronto, Ontario, Canada
| | | | - William Simpson
- Winterlight Labs, Toronto, Ontario, Canada
- McMaster University, Hamilton, Ontario, Canada
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26
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Lower morning levels of cortisol and neuropeptides in blood samples from patients with bipolar disorder. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Cao XJ, Liu XQ. Artificial intelligence-assisted psychosis risk screening in adolescents: Practices and challenges. World J Psychiatry 2022; 12:1287-1297. [PMID: 36389087 PMCID: PMC9641379 DOI: 10.5498/wjp.v12.i10.1287] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/09/2022] [Accepted: 09/22/2022] [Indexed: 02/05/2023] Open
Abstract
Artificial intelligence-based technologies are gradually being applied to psych-iatric research and practice. This paper reviews the primary literature concerning artificial intelligence-assisted psychosis risk screening in adolescents. In terms of the practice of psychosis risk screening, the application of two artificial intelligence-assisted screening methods, chatbot and large-scale social media data analysis, is summarized in detail. Regarding the challenges of psychiatric risk screening, ethical issues constitute the first challenge of psychiatric risk screening through artificial intelligence, which must comply with the four biomedical ethical principles of respect for autonomy, nonmaleficence, beneficence and impartiality such that the development of artificial intelligence can meet the moral and ethical requirements of human beings. By reviewing the pertinent literature concerning current artificial intelligence-assisted adolescent psychosis risk screens, we propose that assuming they meet ethical requirements, there are three directions worth considering in the future development of artificial intelligence-assisted psychosis risk screening in adolescents as follows: nonperceptual real-time artificial intelligence-assisted screening, further reducing the cost of artificial intelligence-assisted screening, and improving the ease of use of artificial intelligence-assisted screening techniques and tools.
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Affiliation(s)
- Xiao-Jie Cao
- Graduate School of Education, Peking University, Beijing 100871, China
| | - Xin-Qiao Liu
- School of Education, Tianjin University, Tianjin 300350, China
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28
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Yap SS, Ramseyer FT, Fachner J, Maidhof C, Tschacher W, Tucek G. Dyadic nonverbal synchrony during pre and post music therapy interventions and its relationship to self-reported therapy readiness. Front Hum Neurosci 2022; 16:912729. [PMID: 36147296 PMCID: PMC9485672 DOI: 10.3389/fnhum.2022.912729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/26/2022] [Indexed: 12/05/2022] Open
Abstract
Nonverbal interpersonal synchronization has been established as an important factor in therapeutic relationships, and the differentiation of who leads the interaction appears to provide further important information. We investigated nonverbal synchrony - quantified as the coordination of body movement between patient and therapist. This was observed in music therapy dyads, while engaged in verbal interaction before and after a music intervention in the session. We further examined associations with patients' self-reported therapy readiness at the beginning of the session. Eleven neurological in-patients participated in this study. Our results showed an increase in both nonverbal synchrony and patient leading after the music intervention. A significant negative correlation was found between self-reported therapy readiness and nonverbal synchrony after the music intervention. These findings point to the empathic ability of the music therapist to sense patients' therapy readiness. Higher patient leading in nonverbal synchrony after the music intervention may thus indicate that the music intervention may have allowed dyadic entrainment to take place, potentially increasing self-regulation and thus empowering patients.
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Affiliation(s)
- Sun Sun Yap
- Department of Health Sciences, Institute of Health Sciences and Midwifery, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
- Josef Ressel Centre for Horizons of Personalised Music Therapy, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Fabian T. Ramseyer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Jörg Fachner
- Josef Ressel Centre for Horizons of Personalised Music Therapy, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Clemens Maidhof
- Josef Ressel Centre for Horizons of Personalised Music Therapy, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Wolfgang Tschacher
- Department of Experimental Psychology, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Gerhard Tucek
- Department of Health Sciences, Institute of Health Sciences and Midwifery, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
- Josef Ressel Centre for Horizons of Personalised Music Therapy, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
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Melatonergic Receptors (Mt1/Mt2) as a Potential Additional Target of Novel Drugs for Depression. Neurochem Res 2022; 47:2909-2924. [PMID: 35689787 PMCID: PMC9187850 DOI: 10.1007/s11064-022-03646-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 11/06/2022]
Abstract
A complex pathogenesis involving several physiological systems is theorized to underline the development of depressive disorders. Depression is accompanied by circadian regulation disruption and interaction with the functioning of both central and peripheral oscillators. Many aspects of melatonin function unite these systems. The use of drugs for circadian rhythm disorders could inspire a potential treatment strategy for depression. Melatonin plays an essential role in the regulation of circadian rhythms. It exerts effect by activating two types of melatonin receptors, type 1A (MT1) and 1B (MT2). These are G-protein-coupled receptors, predominantly located in the central nervous system. MT1/MT2 agonists could be a useful treatment approach according to all three prevalent theories of the pathogenesis of depression involving either monoamines, synaptic remodeling, or immune/inflammatory events. MT1/MT2 receptors can be a potential target for novel antidepressants with impact on concentrations of neurotrophins or neurotransmitters, and reducing levels of pro-inflammatory cytokines. There is an interesting cross-talk mediated via the physical association of melatonin and serotonin receptors into functional heteromers. The antidepressive and neurogenetic effects of MT1/MT2 agonists can also be caused by the inhibition of the acid sphingomyelinase, leading to reduced ceramide, or increasing monoamine oxidase A levels in the hippocampus. Compounds targeting MT1 and MT2 receptors could have potential for new anti-depressants that may improve the quality of therapeutic interventions in treating depression and relieving symptoms. In particular, a combined effect on MT1 and/or MT2 receptors and neurotransmitter systems may be useful, since the normalization of the circadian rhythm through the melatonergic system will probably contribute to improved treatment. In this review, we discuss melatonergic receptors as a potential additional target for novel drugs for depression.
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Gorgol J, Stolarski M, Jankowski KS. The moderating role of personality traits in the associations between seasonal fluctuations in chronotype and depressive symptoms. Chronobiol Int 2022; 39:1078-1086. [PMID: 35450500 DOI: 10.1080/07420528.2022.2067000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Recent research provided evidence that the well-established association between morningness-eveningness and depressive symptoms may be moderated by personality features - conscientiousness and neuroticism. In the present study, we attempted to broaden these findings using a longitudinal design. We hypothesized that these personality traits may influence the degree to which morningness-eveningness and depressiveness covary in time. Participants (n = 380) filled measures of morningness-eveningness, the Big Five personality, and depressive symptoms twice, in December and in June. Consistent with previous results, we observed a significant seasonal shift towards morningness and lower depressive symptoms from December to June. Seasonal shifts in chronotype and depressive symptoms were interrelated: a seasonal shift towards morningness was associated with a decrease in depressive symptoms. The strength of this association was exaggerated by neuroticism but attenuated by conscientiousness, suggesting that among neurotic individuals seasonal changes in depressive symptomatology are more dependent on seasonal shifts in morningness-eveningness but less dependent among conscientious ones. This result suggests that conscientiousness and emotional stability play a protective role against maladaptive consequences of eveningness.
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Affiliation(s)
- Joanna Gorgol
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
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31
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Tubbs AS, Fernandez FX, Grandner MA, Perlis ML, Klerman EB. The Mind After Midnight: Nocturnal Wakefulness, Behavioral Dysregulation, and Psychopathology. FRONTIERS IN NETWORK PHYSIOLOGY 2022; 1:830338. [PMID: 35538929 PMCID: PMC9083440 DOI: 10.3389/fnetp.2021.830338] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Sufficient sleep with minimal interruption during the circadian/biological night supports daytime cognition and emotional regulation. Conversely, disrupted sleep involving significant nocturnal wakefulness leads to cognitive and behavioral dysregulation. Most studies to-date have examined how fragmented or insufficient sleep affects next-day functioning, but recent work highlights changes in cognition and behavior that occur when someone is awake during the night. This review summarizes the evidence for day-night alterations in maladaptive behaviors, including suicide, violent crime, and substance use, and examines how mood, reward processing, and executive function differ during nocturnal wakefulness. Based on this evidence, we propose the Mind after Midnight hypothesis in which attentional biases, negative affect, altered reward processing, and prefrontal disinhibition interact to promote behavioral dysregulation and psychiatric disorders.
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Affiliation(s)
- Andrew S. Tubbs
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine—Tucson, Tucson, AZ, United States
| | - Fabian-Xosé Fernandez
- Department of Psychology, Evelyn F Mcknight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Michael A. Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine—Tucson, Tucson, AZ, United States
| | - Michael L. Perlis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, United States
| | - Elizabeth B. Klerman
- Department of Neurology, Division of Sleep Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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Young CJ, Lyons D, Piggins HD. Circadian Influences on the Habenula and Their Potential Contribution to Neuropsychiatric Disorders. Front Behav Neurosci 2022; 15:815700. [PMID: 35153695 PMCID: PMC8831701 DOI: 10.3389/fnbeh.2021.815700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/27/2021] [Indexed: 12/13/2022] Open
Abstract
The neural circadian system consists of the master circadian clock in the hypothalamic suprachiasmatic nuclei (SCN) communicating time of day cues to the rest of the body including other brain areas that also rhythmically express circadian clock genes. Over the past 16 years, evidence has emerged to indicate that the habenula of the epithalamus is a candidate extra-SCN circadian oscillator. When isolated from the SCN, the habenula sustains rhythms in clock gene expression and neuronal activity, with the lateral habenula expressing more robust rhythms than the adjacent medial habenula. The lateral habenula is responsive to putative SCN output factors as well as light information conveyed to the perihabenula area. Neuronal activity in the lateral habenula is altered in depression and intriguingly disruptions in circadian rhythms can elevate risk of developing mental health disorders including depression. In this review, we will principally focus on how circadian and light signals affect the lateral habenula and evaluate the possibility that alteration in these influences contribute to mental health disorders.
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Gruichich TS, Gomez JCD, Zayas-Cabán G, McInnis MG, Cochran AL. A digital self-report survey of mood for bipolar disorder. Bipolar Disord 2021; 23:810-820. [PMID: 33587813 PMCID: PMC8364560 DOI: 10.1111/bdi.13058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/13/2020] [Accepted: 02/02/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Bipolar disorder (BP) is commonly researched in digital settings. As a result, standardized digital tools are needed to measure mood. We sought to validate a new survey that is brief, validated in digital form, and able to separately measure manic and depressive severity. METHODS We introduce a 6-item digital survey, called digiBP, for measuring mood in BP. It has three depressive items (depressed mood, fidgeting, fatigue), two manic items (increased energy, rapid speech), and one mixed item (irritability); and recovers two scores (m and d) to measure manic and depressive severity. In a secondary analysis of individuals with BP who monitored their symptoms over 6 weeks (n = 43), we perform a series of analyses to validate the digiBP survey internally, externally, and as a longitudinal measure. RESULTS We first verify a conceptual model for the survey in which items load onto two factors ("manic" and "depressive"). We then show weekly averages of m and d scores from digiBP can explain significant variation in weekly scores from the Young Mania Rating Scale (R2 = 0.47) and SIGH-D (R2 = 0.58). Lastly, we examine the utility of the survey as a longitudinal measure by predicting an individual's future m and d scores from their past m and d scores. CONCLUSIONS While further validation is warranted in larger, diverse populations, these validation analyses should encourage researchers to consider digiBP for their next digital study of BP.
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Emerging role of microRNAs as novel targets of antidepressants. Asian J Psychiatr 2021; 66:102906. [PMID: 34740127 DOI: 10.1016/j.ajp.2021.102906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/20/2021] [Indexed: 12/31/2022]
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Mayor E, Bietti LM. Twitter, time and emotions. ROYAL SOCIETY OPEN SCIENCE 2021; 8:201900. [PMID: 34084541 PMCID: PMC8150047 DOI: 10.1098/rsos.201900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 05/06/2021] [Indexed: 06/12/2023]
Abstract
The study of temporal trajectories of emotions shared in tweets has shown that both positive and negative emotions follow nonlinear circadian (24 h) and circaseptan (7-day) patterns. But to this point, such findings could be instrument-dependent as they rely exclusively on coding using the Linguistic Inquiry Word Count. Further, research has shown that self-referential content has higher relevance and meaning for individuals, compared with other types of content. Investigating the specificity of self-referential material in temporal patterns of emotional expression in tweets is of interest, but current research is based upon generic textual productions. The temporal variations of emotions shared in tweets through emojis have not been compared to textual analyses to date. This study hence focuses on several comparisons: (i) between Self-referencing tweets versus Other topic tweets, (ii) between coding of textual productions versus coding of emojis, and finally (iii) between coding of textual productions using different sentiment analysis tools (the Linguistic Inquiry and Word Count-LIWC; the Valence Aware Dictionary and sEntiment Reasoner-VADER and the Hu Liu sentiment lexicon-Hu Liu). In a collection of more than 7 million Self-referencing and close to 18 million Other topic content-coded tweets, we identified that (i) similarities and differences in terms of shape and amplitude can be observed in temporal trajectories of expressed emotions between Self-referring and Other topic tweets, (ii) that all tools feature significant circadian and circaseptan patterns in both datasets but not always, and there is often a correspondence in the shape of circadian and circaseptan patterns, and finally (iii) that circadian and circaseptan patterns obtained from the coding of emotional expression in emojis sometimes depart from those of the textual analysis, indicating some complementarity in the use of both modes of expression. We discuss the implications of our findings from the perspective of the literature on emotions and well-being.
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Affiliation(s)
- Eric Mayor
- Institute of Work and Organizational Psychology, University of Neuchâtel, Rue Emile Argand 11, Neuchâtel 2000, Switzerland
- Division of Clinical Psychology and epidemiology, Department of Psychology, University of Basel, MIssionsstrasse 61a, Basel 4055, Switzerland
| | - Lucas M. Bietti
- Department of Psychology, Norwegian University of Science and Technology, Dragvoll Campus, Trondheim 7491, Norway
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Gisabella B, Babu J, Valeri J, Rexrode L, Pantazopoulos H. Sleep and Memory Consolidation Dysfunction in Psychiatric Disorders: Evidence for the Involvement of Extracellular Matrix Molecules. Front Neurosci 2021; 15:646678. [PMID: 34054408 PMCID: PMC8160443 DOI: 10.3389/fnins.2021.646678] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 04/22/2021] [Indexed: 12/13/2022] Open
Abstract
Sleep disturbances and memory dysfunction are key characteristics across psychiatric disorders. Recent advances have revealed insight into the role of sleep in memory consolidation, pointing to key overlap between memory consolidation processes and structural and molecular abnormalities in psychiatric disorders. Ongoing research regarding the molecular mechanisms involved in memory consolidation has the potential to identify therapeutic targets for memory dysfunction in psychiatric disorders and aging. Recent evidence from our group and others points to extracellular matrix molecules, including chondroitin sulfate proteoglycans and their endogenous proteases, as molecules that may underlie synaptic dysfunction in psychiatric disorders and memory consolidation during sleep. These molecules may provide a therapeutic targets for decreasing strength of reward memories in addiction and traumatic memories in PTSD, as well as restoring deficits in memory consolidation in schizophrenia and aging. We review the evidence for sleep and memory consolidation dysfunction in psychiatric disorders and aging in the context of current evidence pointing to the involvement of extracellular matrix molecules in these processes.
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Affiliation(s)
| | | | | | | | - Harry Pantazopoulos
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, United States
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Tubbs AS, Fernandez FX, Perlis ML, Hale L, Branas CC, Barrett M, Chakravorty S, Khader W, Grandner MA. Suicidal ideation is associated with nighttime wakefulness in a community sample. Sleep 2021; 44:5866613. [PMID: 32614967 DOI: 10.1093/sleep/zsaa128] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 06/19/2020] [Indexed: 12/20/2022] Open
Abstract
STUDY OBJECTIVES Nocturnal wakefulness is a risk factor for suicide and suicidal ideation in clinical populations. However, these results have not been demonstrated in general community samples or compared to sleep duration or sleep quality. The present study explored how the timing of wakefulness was associated with suicidal ideation for weekdays and weekends. METHODS Data were collected from 888 adults aged 22-60 as part of the Sleep and Healthy Activity, Diet, Environment, and Socialization study. Suicidal ideation was measured by the Patient Health Questionnaire-9, while timing of wakefulness was estimated from the Sleep Timing Questionnaire. Binomial logistic regressions estimated the association between nocturnal (11 pm-5 am) and morning (5 am-11 am) wakefulness and suicidal ideation. RESULTS Nocturnal wakefulness was positively associated with suicidal ideation on weekdays (OR: 1.44 [1.28-1.64] per hour awake between 11:00 pm and 05:00 am, p < 0.0001) and weekends (OR: 1.22 [1.08-1.39], p = 0.0018). Morning wakefulness was negatively associated with suicidal ideation on weekdays (OR: 0.82 [0.72-0.92] per hour awake between 05:00 am and 11:00 am, p = 0.0008) and weekends (OR: 0.84 [0.75-0.94], p = 0.0035). These associations remained significant when adjusting for sociodemographic factors. Additionally, nocturnal wakefulness on weekdays was associated with suicidal ideation when accounting for insomnia, sleep duration, sleep quality, and chronotype (OR 1.25 [1.09-1.44] per hour awake, p = 0.002). CONCLUSION Wakefulness at night was consistently associated with suicidal ideation. Additionally, morning wakefulness was negatively associated with suicidal ideation in some models. Although these findings are drawn from a non-clinical sample, larger longitudinal studies in the general population are needed to confirm these results.
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Affiliation(s)
- Andrew S Tubbs
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ
| | - Fabian-Xosé Fernandez
- Department of Psychology, BIO5 and McKnight Brain Research Institutes, University of Arizona, Tucson, AZ
| | - Michael L Perlis
- Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventative Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY
| | | | - Marna Barrett
- Mood and Anxiety Disorders Treatment Research Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Subhajit Chakravorty
- Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Waliuddin Khader
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ
| | - Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ
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Targum SD, Sauder C, Evans M, Saber JN, Harvey PD. Ecological momentary assessment as a measurement tool in depression trials. J Psychiatr Res 2021; 136:256-264. [PMID: 33621911 DOI: 10.1016/j.jpsychires.2021.02.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/21/2021] [Accepted: 02/08/2021] [Indexed: 11/16/2022]
Abstract
We used ecological momentary assessment (EMA) to track symptoms during a clinical trial. Thirty-six participants with major depressive disorder (MDD) and MADRS scores ≥20 were enrolled in a nonrandomized 6-week open-label trial of commercially available antidepressants. Twice daily, a mobile device prompted participants to self-report the 6 items of the HamD6 sub-scale derived from the Hamilton rating scale for depression (HamD17). Morning EMA reports asked "how do you feel now" whereas evening reports gathered a full-day impression. Clinicians who were blinded to the EMA data rated the MADRS, HamD17 and HamD6 at screen, baseline and weeks 2,4, and 6. Hierarchical linear modeling (HLM) examined the course of the EMA assessments and convergence between EMA scores and clinician ratings. HLM analyses revealed strong correlations between AM and PM EMA derived HamD6 scores and revealed significant improvements over time. EMA improvements were significantly correlated with the clinician rated HamD6 scores at endpoint and predicted clinician rated HamD6 score changes from baseline to endpoint (p < .001). There was a large correlation between EMA and clinician derived HamD6 scores at each in-person assessment after baseline. Treatment response defined by EMA matched the clinician rated HamD6 treatment responses in 33 of 36 cases (91.7%). EMA derived symptom scores appear to be efficient and valid measures to track daily symptomatic change in clinical trials and may provide more accurate measures of symptom severity than the episodic "snapshots" that are currently used as clinical outcomes. These findings support further investigation of EMA for assessment in clinical trials.
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Smagula SF, Capps CS, Krafty RT. Evaluating the timing of differences in activity related to depression symptoms across adulthood in the United States. J Affect Disord 2021; 284:64-68. [PMID: 33582433 PMCID: PMC7958982 DOI: 10.1016/j.jad.2021.01.069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/04/2021] [Accepted: 01/29/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Relative activity deficits found in people with (verses without) depression symptoms/disorders may accumulate uniformly throughout the day, or they may tend to be expressed at specific times. Evidence for the latter would suggest times when behavioral approaches are most needed to reduce depression and its health consequences. METHODS We performed a secondary-data analysis of participants who contributed valid accelerometer data at the 2005-2006 National Health and Nutrition Examination Survey (n=4390). Participants were categorized according to the Patient Health Questionnaire-9 standard cut-point of ≥10 (i.e., people with versus without clinically significant depression symptoms). Average levels of accelerometer-measured activity in two-hour bins were the dependent variable in mixed models testing if the relationship between depression status and activity level differed by time of day; and if any such relations varied by age group (18-29 years, 30-44 years, 45-59 years, and 60+ years). RESULTS In adults over the age of 30, people with depression symptoms had generally lower levels of activity across the day, but these effects were most markedly pronounced in the morning hours. We found no differences in activity levels associated with prevalent depression symptoms among people 18-30 years of age. LIMITATIONS Core aspects of depression pathophysiology that produce these different activity patterns and confer their effects on mood were not measured. CONCLUSIONS In adults 30 years and older, efforts to ameliorate relative activity deficits associated with depression may benefit from considering the apparently outsized role of inactivity that occurs in the morning.
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Affiliation(s)
- Stephen F Smagula
- Department of Psychiatry, School of Medicine, University of Pittsburgh, USA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, USA.
| | - Chandler S Capps
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, USA
| | - Robert T Krafty
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, USA
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Mendoza J. Nighttime Light Hurts Mammalian Physiology: What Diurnal Rodent Models Are Telling Us. Clocks Sleep 2021; 3:236-250. [PMID: 33915800 PMCID: PMC8167723 DOI: 10.3390/clockssleep3020014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/16/2021] [Accepted: 03/15/2021] [Indexed: 01/24/2023] Open
Abstract
Natural sunlight permits organisms to synchronize their physiology to the external world. However, in current times, natural sunlight has been replaced by artificial light in both day and nighttime. While in the daytime, indoor artificial light is of lower intensity than natural sunlight, leading to a weak entrainment signal for our internal biological clock, at night the exposure to artificial light perturbs the body clock and sleep. Although electric light at night allows us "to live in darkness", our current lifestyle facilitates nighttime exposure to light by the use, or abuse, of electronic devices (e.g., smartphones). The chronic exposure to light at nighttime has been correlated to mood alterations, metabolic dysfunctions, and poor cognition. To decipher the brain mechanisms underlying these alterations, fundamental research has been conducted using animal models, principally of nocturnal nature (e.g., mice). Nevertheless, because of the diurnal nature of human physiology, it is also important to find and propose diurnal animal models for the study of the light effects in circadian biology. The present review provides an overview of the effects of light at nighttime on physiology and behavior in diurnal mammals, including humans. Knowing how the brain reacts to artificial light exposure, using diurnal rodent models, is fundamental for the development of new strategies in human health based in circadian biology.
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Affiliation(s)
- Jorge Mendoza
- Institute of Cellular and Integrative Neuroscience CNRS UPR3212, University of Strasburg, 8 allée du Général Rouvillois, 67000 Strasbourg, France
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Yu S, Eisenman D, Han Z. Temporal Dynamics of Public Emotions During the COVID-19 Pandemic at the Epicenter of the Outbreak: Sentiment Analysis of Weibo Posts From Wuhan. J Med Internet Res 2021; 23:e27078. [PMID: 33661755 PMCID: PMC7977613 DOI: 10.2196/27078] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/17/2021] [Accepted: 03/01/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The ongoing COVID-19 pandemic has led to an increase in anxiety, depression, posttraumatic stress disorder, and psychological stress experienced by the general public in various degrees worldwide. However, effective, tailored mental health services and interventions cannot be achieved until we understand the patterns of mental health issues emerging after a public health crisis, especially in the context of the rapid transmission of COVID-19. Understanding the public's emotions and needs and their distribution attributes are therefore critical for creating appropriate public policies and eventually responding to the health crisis effectively, efficiently, and equitably. OBJECTIVE This study aims to detect the temporal patterns in emotional fluctuation, significant events during the COVID-19 pandemic that affected emotional changes and variations, and hourly variations of emotions within a single day by analyzing data from the Chinese social media platform Weibo. METHODS Based on a longitudinal dataset of 816,556 posts published by 27,912 Weibo users in Wuhan, China, from December 31, 2019, to April 31, 2020, we processed general sentiment inclination rating and the type of sentiments of Weibo posts by using pandas and SnowNLP Python libraries. We also grouped the publication times into 5 time groups to measure changes in netizens' sentiments during different periods in a single day. RESULTS Overall, negative emotions such as surprise, fear, and anger were the most salient emotions detected on Weibo. These emotions were triggered by certain milestone events such as the confirmation of human-to-human transmission of COVID-19. Emotions varied within a day. Although all emotions were more prevalent in the afternoon and night, fear and anger were more dominant in the morning and afternoon, whereas depression was more salient during the night. CONCLUSIONS Various milestone events during the COVID-19 pandemic were the primary events that ignited netizens' emotions. In addition, Weibo users' emotions varied within a day. Our findings provide insights into providing better-tailored mental health services and interventions.
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Affiliation(s)
- Shaobin Yu
- Department of Public Administration, School of Political Science and Public Administration, Shandong University, Qingdao, China
| | - David Eisenman
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- Center for Public Health and Disasters, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States
| | - Ziqiang Han
- Department of Public Administration, School of Political Science and Public Administration, Shandong University, Qingdao, China
- Center for Crisis Management Research, Tsinghua University, Beijing, China
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Stensvik GT, Helvik AS, Nakrem S, Haugan G. Cornell's Depression for Dementia Scale: A psychometric study among Norwegian nursing home residents. Arch Gerontol Geriatr 2020; 93:104325. [PMID: 33383356 DOI: 10.1016/j.archger.2020.104325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Depression is common among residents in long term-care facilities. Therefore, access to a valid and reliable measure of depressive symptoms among nursing home (NH) residents is highly warranted. AIM The aim of this study was to test the psychometrical properties of the Norwegian version of the Cornell Scale for Depression in Dementia (CSDD). METHODS A sample of 309 NH residents were assessed for depressive symptoms using the CSDD in 2015-2016. Data on CSDD were missing for 64 residents, giving an effective sample of 245 (79.3%). Principal component and confirmatory factor analysis were used. RESULTS A five-dimensional solution yielded the best fit with the data (χ2=174.927, df=94, χ2/df=1.86, p=0.0001, RMSEA=0.058, p-value for test of close fit=0.152, CFI=0.94, TLI=0.92 and SRMR=0.056). As expected, higher depressive symptoms correlated positively with higher scores on the Minimum Data Set Depression Rating Scale (MDSDRS) and correlated negatively with Quality of life assessed with the Quality of Life in Late Stage-Dementia Scale. LIMITATIONS The excluded residents (n=64, 20.7%) had lower cognitive function, which may limit the generalizability of the study results. CONCLUSION This study suggests a five-dimensional solution of the CSDD scale. Sixteen of the 19 original items showed highly significant loadings, explaining a notable amount of the variation in the CSDD-construct. Further development and testing of a well-adapted scale assessing depression in the nursing home population with and without dementia is required.
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Affiliation(s)
- Geir-Tore Stensvik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway..
| | - Anne-Sofie Helvik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.; Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
| | - Sigrid Nakrem
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway..
| | - Gørill Haugan
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.; Nord University, Faculty of Nursing and Health Sciences, Levanger, Norway..
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Heart rate variability (HRV): From brain death to resonance breathing at 6 breaths per minute. Clin Neurophysiol 2020; 131:676-693. [DOI: 10.1016/j.clinph.2019.11.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 10/14/2019] [Accepted: 11/06/2019] [Indexed: 12/13/2022]
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Carissimi A, A. B. Oliveira M, Frey BN, Navarro JF, Hidalgo MP, Adan A. Validation and psychometric properties of the Spanish Mood Rhythm Instrument. BIOL RHYTHM RES 2019. [DOI: 10.1080/09291016.2019.1675023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Alicia Carissimi
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, UFRGS, Porto Alegre, Brasil
| | - Melissa A. B. Oliveira
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, UFRGS, Porto Alegre, Brasil
| | - Benicio N. Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Mood Disorders Program and Women’s Health Concerns Clinic, St. Joseph’s Healthcare, Hamilton, ON, Canada
| | | | - Maria Paz Hidalgo
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, UFRGS, Porto Alegre, Brasil
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
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Tafoya SA, Aldrete-Cortez V, Fossion R, Jaimes AL, Fouilloux C. Indicators of vulnerability associated with less healthy circadian rhythms in undergraduate medical interns. Chronobiol Int 2019; 36:1782-1788. [PMID: 31571499 DOI: 10.1080/07420528.2019.1668403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
To evaluate the association between circadian health parameters and psychological and biological vulnerability, a cross-sectional study was conducted with 15 undergraduate medical interns using the Brief Resilience Scale, the Mini International Neuropsychiatric Interview, and an ambulatory circadian monitoring device. Circadian Health construct was confirmed by factor analysis. Vulnerability factors (history of depression and low resilience) were associated to lower circadian health of motor activity and temperature rhythms. The findings suggest that not only being depressed but also having had depressive episodes in the past, as well as having low resilience, are associated with chronodisruption, and may increase the risk for developing new episodes of depression.
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Affiliation(s)
- Silvia Aracely Tafoya
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad Nacional Autonóma de México, Mexico City, Mexico
| | - Vania Aldrete-Cortez
- Neuroscience and Cognitive Developmental Laboratory, School of Psychology, Universidad Panamericana, Mexico City, Mexico
| | - Rubén Fossion
- Institute of Nuclear Sciences, Universidad Nacional Autonóma de México, Mexico City, Mexico
| | - Aurora Leonila Jaimes
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad Nacional Autonóma de México, Mexico City, Mexico
| | - Claudia Fouilloux
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad Nacional Autonóma de México, Mexico City, Mexico
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Wirz-Justice A, Ajdacic V, Rössler W, Steinhausen HC, Angst J. Prevalence of seasonal depression in a prospective cohort study. Eur Arch Psychiatry Clin Neurosci 2019; 269:833-839. [PMID: 30022319 DOI: 10.1007/s00406-018-0921-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 07/09/2018] [Indexed: 11/28/2022]
Abstract
The prevalence of autumn/winter seasonality in depression has been documented in the longitudinal Zurich cohort study by five comprehensive diagnostic interviews at intervals over more than 20 years (N = 499). Repeated winter major depressive episodes (MDE-unipolar + bipolar) showed a prevalence of 3.44% (5× more women than men), whereas MDE with a single winter episode was much higher (9.96%). A total of 7.52% suffered from autumn/winter seasonality in major and minor depressive mood states. The clinical interviews revealed novel findings: high comorbidity of Social Anxiety Disorder and Agoraphobia within the repeated seasonal MDE group, high incidence of classic diurnal variation of mood (with evening improvement), as well as a high rate of oversensitivity to light, noise, or smell. Nearly twice as many of these individuals as in the other MDE groups manifested the syndrome of atypical depression (DSM-V), which supports the prior description of seasonal affective disorder (SAD) as presenting primarily atypical symptoms (which include hypersomnia and increase in appetite and weight). This long-term database of regular structured interviews provides important confirmation of SAD as a valid diagnosis, predominantly found in women, and with atypical vegetative symptoms.
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Affiliation(s)
- Anna Wirz-Justice
- Centre for Chronobiology, Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Vladeta Ajdacic
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany
| | - Hans-Christoph Steinhausen
- Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
- Clinical Psychology and Epidemiology, Institute of Psychology, University of Basel, Basel, Switzerland
- Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, University of Southern Denmark, Odense, Denmark
| | - Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
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Mendoza J. Circadian insights into the biology of depression: Symptoms, treatments and animal models. Behav Brain Res 2019; 376:112186. [PMID: 31473283 DOI: 10.1016/j.bbr.2019.112186] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 08/27/2019] [Accepted: 08/28/2019] [Indexed: 12/22/2022]
Abstract
In depression, symptoms range from loss of motivation and energy to suicidal thoughts. Moreover, in depression alterations might be also observed in the sleep-wake cycle and in the daily rhythms of hormonal (e.g., cortisol, melatonin) secretion. Both, the sleep-wake cycle and hormonal rhythms, are regulated by the internal biological clock within the hypothalamic suprachiasmatic nucleus (SCN). Therefore, a dysregulation of the internal mechanism of the SCN might lead in the disturbance of temporal physiology and depression. Hence, circadian symptoms in mood disorders can be used as important biomarkers for the prevention and treatment of depression. Disruptions of daily rhythms in physiology and behavior are also observed in animal models of depression, giving thus an important tool of research for the understanding of the circadian mechanisms implicated in mood disorders. This review discusses the alterations of daily rhythms in depression, and how circadian perturbations might lead in mood changes and depressive-like behavior in humans and rodents respectively. The use of animal models with circadian disturbances and depressive-like behaviors will help to understand the central timing mechanisms underlying depression, and how treating the biological clock(s) it may be possible to improve mood.
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Affiliation(s)
- Jorge Mendoza
- Institute of Cellular and Integrative Neurosciences, CNRS UPR-3212 University of Strasbourg, 8 allée du Général Rouvillois, 67000, Strasbourg, France.
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Daut RA, Fonken LK. Circadian regulation of depression: A role for serotonin. Front Neuroendocrinol 2019; 54:100746. [PMID: 31002895 PMCID: PMC9826732 DOI: 10.1016/j.yfrne.2019.04.003] [Citation(s) in RCA: 126] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/13/2019] [Accepted: 04/15/2019] [Indexed: 01/11/2023]
Abstract
Synchronizing circadian (24 h) rhythms in physiology and behavior with the environmental light-dark cycle is critical for maintaining optimal health. Dysregulation of the circadian system increases susceptibility to numerous pathological conditions including major depressive disorder. Stress is a common etiological factor in the development of depression and the circadian system is highly interconnected to stress-sensitive neurotransmitter systems such as the serotonin (5-hydroxytryptamine, 5-HT) system. Thus, here we propose that stress-induced perturbation of the 5-HT system disrupts circadian processes and increases susceptibility to depression. In this review, we first provide an overview of the basic components of the circadian system. Next, we discuss evidence that circadian dysfunction is associated with changes in mood in humans and rodent models. Finally, we provide evidence that 5-HT is a critical factor linking dysregulation of the circadian system and mood. Determining how these two systems interact may provide novel therapeutic targets for depression.
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Affiliation(s)
- Rachel A Daut
- Department of Psychology and Neuroscience, Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA
| | - Laura K Fonken
- University of Texas at Austin, Division of Pharmacology and Toxicology, Austin, TX 78712, USA.
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Circadian reinforcement therapy in combination with electronic self-monitoring to facilitate a safe post-discharge period of patients with depression by stabilizing sleep: protocol of a randomized controlled trial. BMC Psychiatry 2019; 19:124. [PMID: 31023274 PMCID: PMC6485124 DOI: 10.1186/s12888-019-2101-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/03/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The transition phase from inpatient to outpatient care for patients suffering from Major Depressive Disorder represents a vulnerable period associated with a risk of depression worsening and suicide. Our group has recently found that the sleep-wake cycle in discharged depressive patients became irregular and exhibited a drift towards later hours, associated with worsening of depression. In contrast, an advancement of sleep phase has earlier been shown to have an antidepressant effect. Thus, methods to prevent drift of the sleep-wake cycle may be promising interventions to prevent or reduce worsening of depression after discharge. METHODS In this trial, we apply a new treatment intervention, named Circadian Reinforcement Therapy (CRT), to patients discharged from inpatient psychiatric wards. CRT consists of a specialized psychoeducation on the use of regular time signals (zeitgebers): daylight exposure, exercise, meals, and social contact. The aim is to supply stronger and correctly timed zeitgebers to the circadian system to prevent sleep drift and worsening of depression. The CRT is used in combination with an electronic self-monitoring system, the Monsenso Daybuilder System (MDB). By use of the MDB system, all patients self-monitor their sleep, depression level, and activity (from a Fitbit bracelet) daily. Participants can inspect all their data graphically on the MDB interface and will have clinician contact. The aim is to motivate patients to keep a stable sleep-wake cycle. In all, 130 patients referred to an outpatient service will be included. Depression rating is blinded. Patients will be randomized 1:1 to a Standard group or a CRT group. The intervention period is 4 weeks covering the transition phase from inpatient to outpatient care. The primary outcome is score change in interviewer rated levels of depression on the Hamilton Depression Rating Scale. A subset of patients will be assessed with salivary Dim Light Melatonin Onset (DLMO) as a validator of circadian timing. The trial was initiated in 2016 and will end in 2020. DISCUSSION If the described intervention is beneficial it could be incorporated into usual care algorithms for depressed patients to facilitate a better and safer transition to outpatient treatment. TRIAL REGISTRATION Posted prospectively at ClinicalTrials.gov at February 10, 2016 with identifier NCT02679768 .
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50
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Wassing R, Benjamins JS, Talamini LM, Schalkwijk F, Van Someren EJW. Overnight worsening of emotional distress indicates maladaptive sleep in insomnia. Sleep 2018; 42:5261254. [DOI: 10.1093/sleep/zsy268] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/04/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Rick Wassing
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Jeroen S Benjamins
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Social, Health and Organisational Psychology, Utrecht University, Utrecht, The Netherlands
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Lucia M Talamini
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
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