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Journal of affective disorders [journal]
- Cognitive-behavioral therapy for generalized anxiety disorder is associated with attenuation of limbic activation to threat-related facial emotions. [JOURNAL ARTICLE]
- J Affect Disord 2014 Aug 7.:76-85.
The neural processes underlying the benefits of cognitive behavioral treatment (CBT) for generalized anxiety disorder (GAD) are not well understood.Twenty-one (n=21) adults with a principal diagnosis of GAD and eleven (n=11) non-anxious healthy controls (HC) underwent functional magnetic resonance imaging while completing a facial emotion processing task. Responses to threat-related emotionality (i.e., the contrast of fear and angry vs. happy faces) were assessed at pretreatment and again following 10 sessions of CBT in the GAD group and a comparable waiting period in the HC group.At pretreatment, GAD participants displayed blunted responses in the amygdala, insula, and anterior cingulate to the happy face-processing comparison condition, and greater amygdalo-insular connectivity. CBT was associated with amygdalar and subgenual anterior cingulate activation to fear/angry faces and heightened insular responses to the happy face comparison condition, but had no apparent effects on connectivity. Pre-treatment abnormalities and treatment-related changes were not associated with symptoms of worry.There was no active control condition (e.g., treatment waitlist) for comparison of treatment effects.Taken together, these results provide evidence for a dual-process psychotherapeutic model of neural systems changes in GAD in which cingulo-amygdalar reactivity to threat-cues is attenuated while insular responses to positive facial emotions are potentiated. Future work is needed to determine the clinical implications of these changes and their specificity to CBT.
- Risk and protective factors for depression that adolescents can modify: A systematic review and meta-analysis of longitudinal studies. [REVIEW]
- J Affect Disord 2014 Aug 12.:61-75.
Adolescence is a peak time for the onset of depression, but little is known about what adolescents can do to reduce their own level of risk. To fill this gap, a review was carried out to identify risk and protective factors for depression during adolescence that are modifiable by the young person.Employing the PRISMA method, we conducted a systematic review and meta-analysis of longitudinal studies to identify risk and protective factors during the adolescent period (aged 12-18 years) that are potentially modifiable by the young person without professional intervention or assistance. Stouffer׳s method of combining p values was used to determine whether associations between variables were reliable, and meta-analyses were conducted to estimate the mean effect sizes of associations.We identified 113 publications which met the inclusion criteria. Putative risk factors implicated in the development of depression for which there is a sound evidence base, and which are potentially modifiable during adolescence without professional intervention, are: substance use (alcohol, tobacco, cannabis, other illicit drugs, and polydrug use); dieting; negative coping strategies; and weight. Modifiable protective factors with a sound evidence base are healthy diet and sleep.Limitations include not systematically reviewing moderators and mediators, the lack of generalisability across cultures or to younger children or young adults, and the inability to conduct a meta-analysis on all included studies.Findings from this review suggest that future health education campaigns or self-help prevention interventions targeting adolescent depression should aim to reduce substance use (alcohol, tobacco, cannabis, other illicit drugs, and polydrug use); dieting; and negative coping strategies; and promote healthy weight; diet; and sleep patterns.
- Does the installation of blue Lights on train platforms shift suicide to another station?: Evidence from Japan. [JOURNAL ARTICLE]
- J Affect Disord 2014 Aug 7.:57-60.
Installing physical barriers at suicide hotspots is known as an effective strategy for suicide prevention. However, the effectiveness of physical barriers may be nullified by the substitution phenomenon, i.e., that restricting access to a particular place induces people at risk to look for a nearby place for suicide.This study tests whether the substitution phenomenon exists in the case of railway and metro suicides. We focused on the prevention effort by a Japanese railway company that installed blue light-emitting-diode (LED) lamps on railway platforms to prevent people from diving to a running train. Using panel data of 71 train stations between 2000 and 2013, we compared the number of suicides before and after the installation of the blue lights at 14 stations where the lights were installed and at neighboring five stations on the same railway line, using the number of suicides at all other stations without the intervention as a control group.Our regression analysis shows that the introduction of blue lights decreased the number suicides by 74% (CI: 48-87%) at stations where the blue lights were installed, while it did not result in a systematic increase in the number of suicides at the neighboring stations.The installation of blue lights generated no systematic substitution phenomenon at nearby stations.
- Affective temperaments and neurocognitive functioning in bipolar disorder. [JOURNAL ARTICLE]
- J Affect Disord 2014 Aug 5.:51-56.
There is evidence that patients with bipolar disorder (BD) score higher on affective temperament ratings compared to healthy controls (HCs). Moreover, unaffected relatives demonstrate similar patterns as BD patients suggesting that such temperaments are related to the genetic risk for BD and may serve as endophenotypes for the disorder. It is unknown whether affective temperaments are associated with other core features of BD, such as impairments in neurocognition. This study examined the relationship between affective temperaments and neurocognition in patients with BD and in HCs.Temperaments were evaluated using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego, Auto-questionnaire version (TEMPS-A) in 64 patients with BD and 109 HCs. Neurocognitive functioning was evaluated using the MATRICS Consensus Cognitive Battery (MCCB). Correlational analyses between temperaments and cognition were conducted in BD and HC subjects.Data suggest that affective temperaments and neurocognition are correlated. In BD higher ratings of cyclothymia and irritability were associated with better processing speed, working memory, reasoning and problem-solving. In the HC group, increased irritability was related to worse performance on measures of attention and social cognition.Lack of functional outcome measures to evaluate the impact of temperaments and cognition on psychosocial functioning. It would be useful to test these findings on unaffected relatives of BD patients.Cyclothymic and irritable temperaments are correlated with specific aspects of neurocognition in BD. This study is among the few exploring the dimensional relationship between temperaments and cognition in BD, and provides preliminary evidence for future studies investigating the neural and genetic mechanisms underlying the association between these variables.
- Identification of the neural correlates of cyclothymic temperament using an esthetic judgment for paintings task in fMRI. [JOURNAL ARTICLE]
- J Affect Disord 2014 Aug 5.:47-50.
There is a well-known association between artistic creativity and cyclothymic temperament but the neural correlates of cyclothymic temperament have not yet been fully identified. Recently, we showed that the left lingual gyrus and bilateral cuneus may be associated with esthetic judgment of representational paintings, we therefore sought to investigate brain activity during esthetic judgment of paintings in relation to measures of cyclothymic temperament.Regions of interest (ROI) were set at the left lingual gyrus and bilateral cuneus using automated anatomical labeling, and percent signal changes of the ROIs were measured by marsbar toolbox. The associations between percent signal changes of the ROIs during esthetic judgments of paintings and cyclothymic temperament scores were investigated by Pearson׳s coefficient. Moreover, the associations were further analyzed using multiple regression analysis whereby cyclothymic temperament scores were a dependent factor and percent signal changes of the 3 ROIs and the other 4 temperament scores were independent factors.There was a significantly negative association of cyclothymic temperament scores with the percent signal changes of the left lingual gyrus during esthetic judgments of paintings, but not with those of bilateral cuneus. Even after adjustment using multiple regression analysis, this finding remained unchanged.The number of subjects was relatively small and the task was limited to appreciation of paintings.The present findings suggest that cyclothymic temperament may be associated with the left lingual gyrus.
- PTSD prevalence and symptom structure of DSM-5 criteria in adolescents and young adults surviving the 2011 shooting in Norway. [JOURNAL ARTICLE]
- J Affect Disord 2014 Jul 22.:40-46.
Diagnostic criteria for Posttraumatic Stress Disorder (PTSD) have been revised for DSM-5. Two key changes include alteration of the clustering of PTSD symptoms and new PTSD symptom criteria related to negative alterations in cognition and mood. In this study, we empirically investigated these changes.We interviewed 325 adolescents and young adults who survived the 2011 youth camp shooting at Utøya Island, Norway. The UCLA PTSD Reaction Index for DSM-IV was used to assess symptoms of PTSD. In addition, 11 questions were added to assess the four new symptom criteria within the new DSM-5 symptom categories.PTSD prevalence did not differ significantly whether DSM-IV (11.1%) or DSM-5 (11.7%) criteria were used and the Cohen׳s Kappa for consistency between the diagnoses was 0.061. Confirmatory factor analyses showed that the four-factor structure of the DSM-5 fit the data adequately according to the conceptual model outlined.The homogeneity of this sample of highly exposed subjects may preclude generalization to less severely exposed groups. Also, we did not assess criterion G in regard to symptoms causing clinically significant distress and functional impairment.The prevalence of PTSD was quite similar regardless of diagnostic system. The relatively low concordance between the diagnoses has implications for eligibility for a diagnosis of PTSD.
- Long-term Tai Chi training is related to depressive symptoms among Tai Chi practitioners. [JOURNAL ARTICLE]
- J Affect Disord 2014 Jul 31.:36-39.
Due to the close association with physical and psychological health and quality of life, mood disorders, especially depressive symptoms, are an important global public-health issue. It is hypothesized that long-term physical training and mood adjustment may have a beneficial effect on the prevention of the onset of depressive symptoms. The aim of this study was to investigate the relationship between long-term Tai Chi training and depressive symptoms among Tai Chi practitioners.This study analyzed a cross-sectional survey including 529 Japanese Tai Chi practitioners. Tai Chi training information, including total training time and a Tai Chi grade, was assessed using a structured questionnaire, and depressive symptoms were evaluated using the 15-item Geriatric Depression Scale (GDS) for subjects aged ≥65 and the 20-item Self-rating Depressive Scale (SDS) for subjects aged <65 with cut-off points: GDS ≥5 and SDS ≥11.The prevalence of depressive symptoms was 15.9%. After adjustments for potential confounding factors, the odds ratios of having depressive symptoms by increasing levels of Tai Chi training time were 1.00, 0.64 (0.37-1.11), 0.65 (0.37-1.13), 0.34 (0.18-0.65) (P for trend <0.01).This is a cross-sectional study, and not for making a clinical diagnosis of depressive symptoms.This study has demonstrated that long-term Tai Chi training is independently related to a lower prevalence of depressive symptoms. These results suggest that long-term Tai Chi training may have a beneficial effect on the prevention of depressive symptoms. Further studies are needed to confirm these findings.
- Dysfunctional traits in obese women and underweight men. [JOURNAL ARTICLE]
- J Affect Disord 2014 Jul 30.:30-35.
The prevalence of obesity is rapidly increasing worldwide, together with its comorbidities. Our aim was to assess the emotional traits and affective temperaments, according to various Body Mass Index (BMI) groups, in a large sample.Data was collected by a web-survey on psychological and psychiatric measures (BRAINSTEP). The BMI was evaluated by self-reporting and temperament was evaluated by the Affective and Emotional Composite Temperament Scale (AFECTS). The final sample consisted of 10,786 individuals (mean age 27.9±7.8 years, 70% females).About 40% of the sample had a BMI score higher than normal. The overall BMI score was particularly associated with a higher Desire and a lower Control and Volition (p<0.001 for all), especially in women. Obese females also had significantly lower Coping, Stability, and Caution. In males only, underweight individuals were more fearful and sensitive, and they had a lower Coping and Volition character than normal weight subjects, suggesting a more fragile and immature profile. Linear regression with several adjustments confirmed these associations. Regarding affective temperaments, a Depressive type was more prevalent among underweight subjects, an Obsessive type was associated with a normal BMI, and a Hyperthymic type was apparent in overweight individuals of both genders. Underweight males and females were more prone to having an internalized temperament.Only self-reporting measures were used in a cross-sectional design.Obese women and underweight men have a more dysfunctional trait profile. Addressing these traits may be important for prevention strategies and, possibly, for weight reduction in women.
- A web-based self-management intervention for Bipolar Disorder 'Living with Bipolar': A feasibility randomised controlled trial. [JOURNAL ARTICLE]
- J Affect Disord 2014 Jul 27.:21-29.
Bipolar Disorder (BD) is a severe mental health problem. Psychological interventions are recommended by the National Institute for Health and Care Excellence (NICE) but patients experience severe inequalities in access. This study assessed the feasibility and potential effectiveness of a recovery informed web-based self-management intervention for people with BD.An online randomised controlled trial (n=122) compared treatment as usual (TAU) plus the 'Living with Bipolar' (LWB) intervention with a waiting list control (WLC) group.The study recruited to target and the retention rates were high. Participants engaged with the approach. Compared with the WLC, those receiving LWB showed the most robust improvement in psychological and physical domains of quality of life, wellbeing and recovery at the end of the intervention.The trial was not definitive and requires further investigation.There is preliminary evidence that a web-based treatment approach in BD is feasible and potentially effective. Such interventions could form part of the Improving Access to Psychological Therapy (IAPT) initiative in severe mental health.
- A review of the relationship between proinflammatory cytokines and major depressive disorder. [REVIEW]
- J Affect Disord 2014 Jul 30.:15-20.
Determining etiological factors and reviewing advances in diagnostic modalities sensitive and specific to Major Depressive Disorder (MDD) is of importance in its evaluation and treatment. The inflammatory hypothesis is one of the most prevalent topics concerning MDD and may provide insight into the pathogenesis of depression, development of biomarkers, and ultimately production of more effective depression therapies.We reviewed several studies to evaluate contemporary concepts concerning proinflammatory cytokines and their relationship to various depressive disorders, the use of anti-inflammatory therapies in MDD treatment, and the application of neuroimaging in conjunction with cytokine profiles from both plasma and CSF as possible diagnostic tools.Proinflammatory cytokines in both plasma and CSF have been found to influence the progression and severity of depressive disorders in different populations. Studies have shown elevated serum levels of IL-1, IL-6, TNF-α, CRP, and MCP-1 in depressed patients, but have presented mixed results with IL-8 serum levels, and with IL-6 and MCP-1 CSF levels. Anti-inflammatory treatment of MDD may have adjuvant properties with current depression medications. MRI and NIRS neuroimaging confirm neurological abnormalities in the presence of elevated proinflammatory cytokines in depressed or stressed patients.Heterogeneity of MDD and limited CSF cytokine research complicate the study of MDD pathogenesis.There is significant evidence that inflammatory processes influence the development and progression of MDD. Future studies with larger arrays of cytokine profiles aided by neuroimaging may provide more sensitive and specific modes of diagnostics in determining MDD etiology and provide guidance in individual therapies.