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Journal of affective disorders [journal]
- Cry1 and Tef gene polymorphisms are associated with major depressive disorder in the Chinese population. [Journal Article]
- J Affect Disord 2014 Mar 20.:100-3.
Accumulating evidences indicate that circadian abnormalities lead to sleep disorder, neurodegenerative diseases and depression. We have reported that the polymorphisms of a clock-related gene, Tef, contributed to the risk of sleep disturbances and depression in the Parkinson disease. The objective of the present study was to examine whether the three clock genes we previously studied are associated with major depressive disorder (MDD) in the Chinese population.105 Subjects with MDD and 485 control subjects participated in this case-control study. Demographics, Mini-mental Status Examination (MMSE), and the Hamilton rating scale for depression (HAMD) were obtained in all subjects. Genotypes of single nucleotide polymorphisms (SNPs) of Cry1 rs2287161, Cry2 rs10838524 and Tef rs738499 were screened by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).MDD cases had a significantly higher frequency carrying the C allele and CC genotype in Cry1 rs2287161 and the T allele and TT genotype in Tef rs738499 than controls.The sample size of MDD group was relatively small.The polymorphisms of Cry1 rs2287161 and Tef rs738499 are associated to MDD.
- The prevalence, clinical correlates and structure of phobic fears in Han Chinese women with recurrent major depression. [Journal Article]
- J Affect Disord 2014 Mar 20.:92-9.
Phobic fears are common in the general population and among individuals with major depression (MD). We know little about the prevalence, clinical correlates, and structure of phobic fears in Chinese women with MD.We assessed 22 phobic fears in 6017 Han Chinese women with MD. We used exploratory factor analysis to examine the structure of these phobic fears. We examined the relationship between individual phobic fears and the severity of MD, neuroticism, comorbid panic disorder, generalized anxiety disorder and dysthymia using logistic regression models.The frequency of phobic fears ranged from 3.0% (eating in public) to 36.0% (snakes). Phobic fears were significantly associated with more severe MD, high neuroticism, and co-morbid panic disorder, generalized anxiety disorder and dysthymia. Our factor analysis suggested four underlying subgroups of phobic fears which differed in their clinical correlates, severity and patterns of comorbidity.Data were collected retrospectively through interview and recall bias may have affected the results.Phobic fears are correlated with comorbid MD and more severe MD. These phobic fears clearly subdivide into four subgroups that differ meaningfully from each other.
- Further evidence for plasma progranulin as a biomarker in bipolar disorder. [Journal Article]
- J Affect Disord 2014 Mar 20.:87-91.
A recent study suggested that progranulin (encoded by the fronto-temporal dementia risk gene GRN) plasma levels are decreased in bipolar disorder (BD). Replication of this finding is however lacking.Progranulin plasma levels of bipolar patients (n=104) and healthy controls (n=80) were measured by enzyme-linked immunosorbent assay (ELISA). Participants were also genotyped for three single nucleotide polymorphisms (SNPs) in the GRN gene (rs2879096, rs4792938 and rs5848), and the effect of genetic variation on progranulin levels was examined.Plasma progranulin levels were decreased in BD (ANCOVA, p=0.001). Furthermore, age was significantly and positively correlated with plasma progranulin (Pearson׳s correlation, r=0.269, p<0.001). Also, lithium treatment but no other medication had a significant effect on progranulin plasma levels (ANCOVA, p=0.007). Specifically in BD, the GRN SNP rs5848 was associated with progranulin plasma levels (Kruskal-Wallis test, p<0.005).Subgroup analysis regarding bipolar I vs. bipolar II subtype and polarity of the episode at sampling (manic vs. depressed vs. mixed vs. rapid cycling vs. euthymic) could only be performed with limited validity due to the relatively small sample size. The suitability of peripheral progranulin as a biomarker for BD is limited due to the overlap between patients and controls.The findings strengthen the evidence for progranulin being involved in pathomechanisms of bipolar disorder, and suggest a genetic determinant of progranulin concentrations that is relevant specifically in bipolar patients.
- Exploring the associations between genetic variants in genes encoding for subunits of calcium channel and subtypes of bipolar disorder. [Journal Article]
- J Affect Disord 2014 Mar 20.:80-6.
Associations of two voltage-gated calcium channel (Cav) genes, CACNA1C and CACNB2, were identified for bipolar disorder (BP) in different ethnic groups in recent genome-wide association studies. The current study aimed to evaluate the associations of several Cav genes and subtypes of BP in genetically more homogeneous Taiwanese samples. Additionally, we tested interaction effects among genes that encode for α1, β and γ-subunits of calcium channel.8 Cav genes were selected based on evidence in prior association studies and significant linkage regions for BP. 280 BP patients and 200 controls were recruited. Multifactor dimensionality reduction was performed for interaction testing in these discovery samples. Replication was conducted for two markers using additional 495 Taiwanese cases and 1341 controls.Weak associations for CACNA1C (rs10848635), CACNA1E (rs10848635), CACNB2 (rs11013860), and CACNG2 (rs2284018) genes were observed. Joint analysis of four markers revealed higher accumulative risk with increasing numbers of risk genotypes an individual endorsed for BP-I (Ptrend=0.006) and BP-II (Ptrend=0.017) disorders. Combined analysis with independent replication samples further supported the association of rs11013860 in CACNB2 with BP subtype I (P=1×10(-6)). Suggestive interactions were found between genes encoded for different subunits of calcium channel (α1, β, and γ).Moderate sample size and incomplete markers coverage for the chosen Cav genes.Our results support the involvement of different calcium channel genes in bipolar illness, in particular the beta-subunit in the Asian population. Further investigation of functional property of these genes can contribute on understanding the etiological mechanisms of bipolar illness.
- Age at onset of recurrent major depression in Han Chinese women - A replication study. [Journal Article]
- J Affect Disord 2014 Mar 20.:72-9.
The relationship between age at onset (AAO) and major depression (MD) has been studied in US, European and Chinese populations. However, larger sample studies are needed to replicate and extend earlier findings.We re-examined the relationship between AAO and the clinical features of recurrent MD in Han Chinese women by analyzing the phase I (N=1848), phase II (N=4169) and total combined data (N=6017) from the CONVERGE project. Linear, logistic, multiple linear and multinomial logistic regression models were used to determine the association of AAO with continuous, binary and categorical variables.The effect size of the association between AAO and clinical features of MD was quite similar in the phase I and phase II samples. These results confirmed that MD patients with earlier AAO tended to suffer more severe, recurrent and chronic illness and cases of MD with earlier AAO showed increased neuroticism, greater family history and psychiatric comorbidity. In addition, we showed that earlier AAO of MD in Han Chinese women was associated with premenstrual symptoms, postnatal depression, a highly authoritarian or cold childhood parental rearing style and a reduced probability for having melancholia.Data were collected retrospectively through interview and recall bias may have affected the results.MD with earlier AAO in Han Chinese women shows a distinct set of clinical features which are similar to those reported in Western populations.
- rTMS in resistant mixed states: An exploratory study. [Journal Article]
- J Affect Disord 2014 Mar 20.:66-71.
Repetitive transcranial magnetic stimulation (rTMS) has shown efficacy in resistant unipolar depression, but its efficacy in bipolar disorders has not yet been extensively investigated. Mixed episodes are reported in up to 40% of acute bipolar admissions and are associated with severe psychopathology, comorbidity, high risk of suicide and poor treatment response. Right low-frequency rTMS (LF-rTMS) as an augmentation treatment might be effective for mixed states.Forty patients were treated during a 4-week period with a mood stabilizer and subsequent rTMS (low frequency stimulation - 1Hz - applied to the right Dorso-Lateral Prefrontal Cortex (DLPFC)) as add-on treatment for 3 weeks. Response to LF-rTMS was assessed by the Hamilton Depression Rating Scale (HAM-D), the Young Mania Rating Scale (YMRS) and the Clinical Global Impressions-Bipolar Version (CGIBP) subscales. ANOVA with repeated measures performed on HAM-D, YMRS and CGI-BP subscales "change from the preceding phase" and "severity of illness" showed a statistically significant time effect from the baseline to the endpoint.For the HAM-D there was a 46.6% responder rate, of which 28.6% was remitted, while for the YMRS there was a 15% responder rate, all of which was remitted.The open label-design of our study and the lack of a sham-controlled group represent a methodological limitation.The results suggest that LF-rTMS on the right DLFC might be a potential augmentation strategy in the treatment of both depressive and manic symptoms in mixed states.
- Impairment of work productivity in panic disorder patients. [Journal Article]
- J Affect Disord 2014 Mar 20.:60-5.
Panic disorder (PD) has a critical impact on productivity at the workplace. This study aimed to identify the lost productivity time (LPT) for patients with PD. It also assessed change in LPT for patients with PD after 12 weeks of treatment with Selective Serotonin Reuptake Inhibitors (SSRIs), compared with healthy controls.Working patients diagnosed with PD without other major medical or psychiatric illness were enrolled at outpatient psychiatric clinics (N=108). Age and sex-matched healthy controls were recruited through advertisement (N=108). Health and productivity, PD symptoms, and depressive symptoms were assessed using the Korean version of the World Health Organization's Health and Work Performance Questionnaire (HPQ), the Panic Disorder Severity Scale (PDSS), and the Hamilton Rating Scales for Depression (HAM-D), respectively at baseline, week 4, and week 12.At baseline, the PD group showed significantly higher LPT compared to the control group (103.02 vs. 47.28h in the past 4 weeks). After 12 weeks of treatment, the PD group displayed significant clinical improvement as well as improved productivity with a marked reduction in LPT. Among the patients who completed the treatment, LPT due to PD was reduced from 104.38 to 55.15h in the past 4 weeks.There may be selection bias due to case-control study design.These data suggest that, after the treatment, there was significant improvement in clinical symptoms, and that productivity loss due to PD was almost entirely recovered to the level of healthy controls after 12 weeks of psychiatric outpatient treatment.
- Emotion regulation strategies in bipolar II disorder and borderline personality disorder: Differences and relationships with perceived parental style. [Journal Article]
- J Affect Disord 2014 Mar 20.:52-9.
Bipolar II disorder (BP II) and Borderline Personality Disorder (BPD) share common features and can be difficult to differentiate, contributing to misdiagnosis and inappropriate treatment. Research contrasting phenomenological features of both conditions is limited. The current study sought to identify differences in emotion regulation strategies in BP II and BPD in addition to examining relationships with perceived parental style.Participants were recruited from a variety of outpatient and community settings. Eligible participants required a clinical diagnosis of BP II or BPD, subsequently confirmed via structured diagnostic interviews assessing DSM-IV criteria. Participants completed a series of self-reported questionnaires assessing emotion regulation strategies and perceived parental style.The sample comprised 48 (n=24 BP II and n=24 BPD) age and gender-matched participants. Those with BPD were significantly more likely to use maladaptive emotion regulation strategies, less likely to use adaptive emotion regulation strategies, and scored significantly higher on the majority of (perceived) dysfunctional parenting sub-scales than participants with BP II. Dysfunctional parenting experiences were related to maladaptive emotion regulation strategies in participants with BP II and BPD, however differential associations were observed across groups.Relatively small sample sizes; lack of a healthy control comparator group; lack of statistical control for differing sociodemographic and clinical characteristics, medication and psychological treatments; no assessment of state or trait anxiety; over-representation of females in both groups limiting generalisability of results; and reliance on self-report measures.Differences in emotion regulation strategies and perceived parental style provide some support for the validity of distinguishing BP II and BPD. Development of intervention strategies targeting the differing forms of emotion regulatory pathology in these groups may be warranted.
- Air pollution as a risk factor for depressive episode in patients with cardiovascular disease, diabetes mellitus, or asthma. [Journal Article]
- J Affect Disord 2014 Mar 20.:45-51.
There is currently insufficient evidence to confirm the effect of ambient air pollution on mental disorders, especially among susceptible populations. This study investigated the short-term effect of ambient air pollution on the risk of depressive episode and the effect modification across disease subpopulations.Subjects who visited the emergency department (ED) for depressive episode from 2005 to 2009 (n=4985) in Seoul, Republic of Korea were identified from medical claims data. We conducted a time-stratified case-crossover study using conditional logistic regression. Subgroup analyses were conducted after the subjects were stratified by underlying disease (cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease, asthma, and depressive disorder). The risk was expressed as an odds ratio (OR) per 1 standard deviation of each air pollutant.SO2, PM10, NO2, and CO were positively associated with ED visits for depressive episode. The maximum risk was observed in the distributed lag 0-3 model for PM10 (OR, 1.120; 95% confidence interval, 1.067-1.176). PM10, NO2, and CO significantly increased the risks of ED visits for depressive episode in subjects with either underlying cardiovascular disease, diabetes mellitus, asthma, or depressive disorder.Our data may include a misclassification bias due to the validity of a diagnosis determined from medical services utilization data.SO2, PM10, NO2, and CO significantly increased the risk of ED visits for depressive episode, especially among individuals with pre-existing cardiovascular disease, diabetes mellitus, or asthma.
- A preliminary report of increased plasma levels of IL-33 in bipolar disorder: Further evidence of pro-inflammatory status. [Journal Article]
- J Affect Disord 2014 Mar 20.:41-4.
Recent findings suggest an important role for inflammation in the neurobiology of bipolar disorder (BD). Interleukin 33 (IL-33) is a cytokine with multiple functions and may act as a nuclear factor regulating transcription and as an "alarmin". IL-33 exerts part of its function through the receptor ST2 that also exists in a soluble form (sST2). This study was performed to evaluate IL-33 and sST2 plasma levels in BD patients.We evaluated IL33 and sST2 plasma levels of 46 BD patients (23 in euthymia and 23 in mania) and 23 healthy controls using enzyme-linked immunosorbent assay (ELISA). BD patients were age and gender matched healthy controls.IL-33 levels were higher in BD patients (p=0.02) but there was no difference in sST2 (p=0.55). IL33 and sST2 plasma levels were not correlated with age, neither was influenced by clinical comorbidities nor medications in use.These findings corroborate the view of BD as a multisystem condition with a proinflammatory profile.