Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management

World Psychiatry, Journal Year: 2023, Volume and Issue: 22(3), P. 366 - 387

Published: Sept. 15, 2023

Populations with common physical diseases – such as cardiovascular diseases, cancer and neurodegenerative disorders experience substantially higher rates of major depressive disorder (MDD) than the general population. On other hand, people living MDD have a greater risk for many diseases. This high level comorbidity is associated worse outcomes, reduced adherence to treatment, increased mortality, health care utilization costs. Comorbidity can also result in range clinical challenges, more complicated therapeutic alliance, issues pertaining adaptive behaviors, drug‐drug interactions adverse events induced by medications used mental disorders. Potential explanations prevalence above involve shared genetic biological pathways. These latter include inflammation, gut microbiome, mitochondrial function energy metabolism, hypothalamic‐pituitary‐adrenal axis dysregulation, brain structure function. Furthermore, several antecedents related social factors (e.g., socioeconomic status), lifestyle variables activity, diet, sleep), stressful live childhood trauma). Pharmacotherapies psychotherapies are effective treatments comorbid MDD, introduction interventions well collaborative models digital technologies provide promising strategies improving management. paper aims detailed overview epidemiology specific including bidirectional risk; pathways potentially implicated pathogenesis diseases; socio‐environmental that serve both protective factors; management prevention treatment. We conclude future directions emerging research optimal

Language: Английский

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Prevalence and trends of common mental disorders from 2007‐2009 to 2019‐2022: results from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS), including comparison of prevalence rates before vs. during the COVID‐19 pandemic

World Psychiatry, Journal Year: 2023, Volume and Issue: 22(2), P. 275 - 285

Published: May 9, 2023

Up‐to‐date information on the prevalence and trends of common mental disorders is relevant to health care policy planning, owing high burden associated with these disorders. In first wave third Netherlands Mental Health Survey Incidence Study (NEMESIS‐3), a nationally representative sample was interviewed face‐to‐face from November 2019 March 2022 (6,194 subjects; 1,576 before 4,618 during COVID‐19 pandemic; age range: 18‐75 years). A slightly modified version Composite International Diagnostic Interview 3.0 used assess DSM‐IV DSM‐5 diagnoses. Trends in 12‐month rates were examined by comparing between NEMESIS‐3 NEMESIS‐2 (6,646 18‐64 years; 2007 July 2009). Lifetime estimates 28.6% for anxiety disorders, 27.6% mood 16.7% substance use 3.6% attention‐deficit/hyperactivity disorder. Over last 12 months, 15.2%, 9.8%, 7.1%, 3.2%, respectively. No differences vs. pandemic found (26.7% pre‐pandemic 25.7% pandemic), even after controlling socio‐demographic characteristics respondents two periods. This case all four disorder categories. From 2007‐2009 2019‐2022, rate any significantly increased 17.4% 26.1%. stronger increase students, younger adults (18‐34 years) city dwellers. These data suggest that has past decade, but this not explained pandemic. The already risk young particularly further recent years.

Language: Английский

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Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization

Nature Medicine, Journal Year: 2023, Volume and Issue: 29(10), P. 2498 - 2508

Published: Aug. 31, 2023

Post-COVID cognitive deficits, including 'brain fog', are clinically complex, with both objective and subjective components. They common debilitating, can affect the ability to work, yet their biological underpinnings remain unknown. In this prospective cohort study of 1,837 adults hospitalized COVID-19, we identified two distinct biomarker profiles measured during acute admission, which predict outcomes 6 12 months after COVID-19. A first profile links elevated fibrinogen relative C-reactive protein deficits. second D-dimer deficits occupational impact. This was mediated by fatigue shortness breath. Neither significantly depression or anxiety. Results were robust across secondary analyses. replicated, specificity COVID-19 tested, in a large-scale electronic health records dataset. These findings provide insights into heterogeneous biology post-COVID

Language: Английский

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Trends in Incident Prescriptions for Behavioral Health Medications in the US, 2018-2022

JAMA Psychiatry, Journal Year: 2024, Volume and Issue: 81(4), P. 396 - 396

Published: Jan. 10, 2024

Importance The COVID-19 pandemic reportedly increased behavioral health needs and impacted treatment access. Objective To assess changes in incident prescriptions dispensed for medications commonly used to treat depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), opioid use (OUD), before during the pandemic. Design, Setting, Participants This was a cross-sectional study using comprehensive, population-level, nationally projected data from IQVIA National Prescription Audit on (prescriptions patients with no prior dispensing same drug class previous 12 months) antidepressants, benzodiazepines, Schedule II (C-II) stimulants, nonstimulant ADHD, buprenorphine-containing medication OUD (MOUD), US outpatient pharmacies. Data were analyzed April 2018 March 2022. Exposure Incident by (by prescriber specialty, patient age, sex) drug. Main Outcomes Measures Interrupted time-series analysis compare trends monthly percentage aggregate between Results 5 classes changed 51 500 321 54 000 169 largest unadjusted increase specialty among nurse practitioners across all ranging 7% (from 1 811 376 944 852; benzodiazepines) 78% 157 578 280 925; buprenorphine MOUD), whereas age sex, increases within C-II stimulants ADHD drugs aged 20 39 years (30% [from 887 017 2 455 706] 81% 255 053 461 017], respectively) female (25% 352 095 942 604] 59% 395 678 630 678], respectively). Trends (slope change: 4007 per month; 95% CI, 1592-6422 1120 706-1533, significantly pandemic, exceeding prepandemic after an initial drop at onset of (level changes: −50 044 prescriptions; −80 202 −19 886 −12 876 −17 756 −7996, Although MOUD dropped −2915 −5513 −318), did not change MOUD, or benzodiazepines. Conclusions Relevance many remained relatively stable US, medications, notably sharply increased. Additional research is needed differentiate due unmet need vs overprescribing, highlighting further guideline development define appropriateness.

Language: Английский

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Editorial: Cognitive and mental health improvement under- and post-COVID-19

Frontiers in Psychology, Journal Year: 2025, Volume and Issue: 16

Published: March 6, 2025

Being infected by COVID-19 represents a major psychological stressor, with the virus itself exerting direct biological effects that may contribute to cognitive and mental health challenges. In retrospective study conducted in Brazil, Bonfim et al reported 24% of 630 outpatients, confirmed positive between December 2020 March 2022, exhibited symptoms. These symptoms ranged from difficulties attention memory impaired thinking. Depression, fatigue, female gender were identified as risk factors for these Similarly, Li surveying 482 patients China 2022 June 2023, found 13% experienced depression, 27% anxiety, 25% stress. The severity long-term COVID correlated poorer outcomes, while resilience social support emerged protective factors.While infection-control measures have been effective limiting spread virus, they often come at cost health. For example, Barbalat nationwide online survey during France's first lockdown (March-May 2020), involving approximately 19,000 participants. They observed gradual decline over course lockdown, psychiatric conditions concerns about access equipment serving factors. Conversely, optimism pandemic's trajectory, neighborhood support, participation collective actions Qing examined impact campus lockdowns on Chinese university students elevated levels stress depression compared pre-lockdown periods. Using latent class mixed models, authors distinct trajectories unfavorable peer relationships more likely experience trajectories.Healthcare professionals, frequently exposed heavy workloads, high challenges pandemic 15 . Zhu surveyed 145 members medical security team Winter Olympic Games Paralympics longer work durations associated worse including higher anxiety. Females particularly vulnerable. Such findings underscore unique pressures faced frontline workers public crises. extends beyond physical well-being motivation. Vega-Fernández al, 161 Chilean school teachers late 2021, 98% musculoskeletal disorders past year. quality life. this study, females also disorders. Tang & He college depressive showed reduced academic engagement, highlighting broader motivational consequences struggles.As become milder restrictions relaxed, new emerged. Hao after eased its control January one five individuals over-concern characterized obsessive thoughts anxiety regarding infection. Poor self-rated worries family contracting over-concerns. Cheng 2,000 healthcare professionals shortly relaxations, half gender, younger age, low professional rank, working hours another Jiang further suggested reciprocal problems job burnout period.Despite general decrease infection isolation winds down, studies indicate loneliness, heightened stringent quarantine measures, has not fully returned pre-pandemic 13,14 de Vroege van dex Broek 510 improvements work-life balance reductions complaints postpandemic earlier stages. However, 36% increased 21% depression. Wang, Zhang, noted four 2023 levels. emphasize importance ongoing monitoring tailored care, even subsides. Not all outcomes negative. Some demonstrated posttraumatic growth, deeper appreciation life meaningful interpersonal relationships. Zeng 39% resident physicians growth. Satisfaction income sufficient workplace key highlight potential foster growth offer pathway improved outcomes.Female gender. A consistent factor above mentioned is being (Bonfim al). This difference finding; epidemiological long are developing disorders, 16 17 Several mechanisms proposed explain vulnerability. instance, severe forms adverse childhood experiences, predisposing them 18 Moreover, engage rumination (i.e., repetitive passive focus negative emotional experiences) 19 exhibit risk-aversive behaviors situations 20 less intense activity 21 , which benefits 22,23 Another explanation highlighted Sasaki who investigated role emotion malleability beliefs. Their suggest hold fixed beliefs cannot or change their emotions. linked distress prevalent among women, those under 45 years old, Social support. extensive evidence 24,25 crucial factor. addition Shi lower enhance perceived control, lack could lead sense helplessness, development states 26 Perceived promotes problem-focused coping strategies help address stressors, maladaptive strategies, such avoidance, rumination, suppression, increase psychopathology 27 .Self-control. Self-control appeared an important correlation self-control irritability students. network analysis, impulse bridge symptoms, resistance temptation acted Self-control, enables manage emotions, behaviors, thoughts, determinant 28 29 .Leisure engagement. self-control, active leisure engagement against Kulbin using profile categorized 439 Estonia adults into based changes coping. participants healthiest exercise, spending time nature, pursuing hobbies. activities known promote (see next section) [30][31][32] .Together, multifaceted approach well-being, combining psychological, behavioral, mitigate psychopathology.The current collection offers valuable insights various intervention health.Physical exercise. Tian, Luo systematic review meta-analysis assess exercise interventions Based 12 studies, estimated effect size follows: standardized mean (SMD) =-1.02 (95% CI: -1.42 -0.62); SMD = -0.81 -1.10 -0.52); stress, -1.05 -1.33 -0.78). greatest single sessions lasting 30-40 minutes frequency 3-5 times per week. align supporting regular [21][22][23][31][32][33][34][35] behind include release neurotrophic factors, endorphins, endocannabinoids, along activation dopamine serotonin neurotransmitter systems 22,23,[35][36][37] .Nature contact. Patwary outdoors green spaces significantly health, reducing finding growing interest nature horticultural therapy [38][39][40][41][42] contact relaxation brain, well endocrine immune Furthermore, engaging interactions, loneliness enhancing 43 .Mindfulness. Melvin qualitative, interpretative phenomenological analysis facilitators mindfulness program pandemic. Mindfulness practices, meditation yoga, shown alleviate body awareness, attention, regulation, facilitating perspective shifts clarifying values 44,45 both delivering programs online, providing future programs.Wong evaluated 8-week smartphone-delivered multicomponent lifestyle medicine through randomized controlled trial nonclinical sample. combined changes, healthy eating, practices like yoga. While no focused solely nutrition, supports critical nutrition proper brain function 46,47 combination expected synergistic effects. Wong overall insomnia, sizes ranging 0.13 0.56 (Cohen's d). Notably, persisted 1-month follow-up.Light therapy. Chen light adolescents young adults. were: SMD=-2.1 -2.5 -1.68) concurrent medications, SMD=-1.03 -1.27 -0.78) without medications. Light thought reset altered circadian seasonal rhythms 48 performed additional analyses determine optimal dosing guidelines, clinical applications.We hope Research Topic offered perspectives exacerbated them. intricate interplay shaping outcomes. calls holistic combines individual systemic care strengthened community By addressing issues collaborative interdisciplinary approach, we can transform lessons improve generations. We inspires research, innovation, policy meet

Language: Английский

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Psychological Factors Explaining the COVID-19 Pandemic Impact on Mental Health: The Role of Meaning, Beliefs, and Perceptions of Vulnerability and Mortality

Behavioral Sciences, Journal Year: 2023, Volume and Issue: 13(2), P. 162 - 162

Published: Feb. 13, 2023

This study tested an expanded version of the explanatory model negative impact COVID-19 pandemic on mental health proposed by Milman and colleagues. Participants (N = 680) completed online survey demographic variables associated with poor health, stressors, symptoms, pandemic-related psychological processes we hypothesized as mediating mechanisms explaining effects stressors. Results indicated that these (core belief violation, meaning made pandemic, vulnerability, mortality perception) explained severity symptoms to a far greater extent than stressors demographics combined. In addition, mediated all outcomes. Specifically, were increased core decreased making, more intense perceived vulnerability mortality. turn, those whose beliefs violated who less pronounced experienced worse condition. study's results suggest some possible ways intervention in pandemic-like events useful for limiting such at individual, group, social political levels.

Language: Английский

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Nationwide health, socio-economic and genetic predictors of COVID-19 vaccination status in Finland

Nature Human Behaviour, Journal Year: 2023, Volume and Issue: 7(7), P. 1069 - 1083

Published: April 20, 2023

Abstract Understanding factors associated with COVID-19 vaccination can highlight issues in public health systems. Using machine learning, we considered the effects of 2,890 health, socio-economic and demographic entire Finnish population aged 30–80 genome-wide information from 273,765 individuals. The strongest predictors status were labour income medication purchase history. Mental conditions having unvaccinated first-degree relatives reduced vaccination. A prediction model combining all achieved good discrimination (area under receiver operating characteristic curve, 0.801; 95% confidence interval, 0.799–0.803). 1% individuals highest predicted risk not vaccinating had an observed rate 18.8%, compared 90.3% study population. We identified eight genetic loci uptake derived a polygenic score, which was weak predictor independent subset. Our results suggest that at higher suffering worst consequences are also less likely to vaccinate.

Language: Английский

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Neuropsychiatric disorders following SARS-CoV-2 infection

Brain, Journal Year: 2023, Volume and Issue: 146(6), P. 2241 - 2247

Published: Feb. 2, 2023

Abstract Several large-scale electronic health records studies have reported increased diagnostic rates for neuropsychiatric disorders following Coronavirus disease 2019 [COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 infection)], but many questions remain. To highlight the issues, we selectively review this literature, focusing on mood disorder, anxiety psychotic and cognitive impairment (‘brain fog’). Eight key are addressed, comprising: (i) nature magnitude of risks; (ii) their association with severity infection; (iii) duration; (iv) whether risks differ between adults children, men women; (v) prior vaccination protects against them; (vi) risk profile associated different SARS-CoV-2 strains; (vii) what underlying mechanisms might be; (viii) sequelae can be predicted. We consider major unknowns, limitations research in area, use additional approaches to help characterize understand burden COVID-19.

Language: Английский

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Long-term risk of psychiatric disorder and psychotropic prescription after SARS-CoV-2 infection among UK general population

Nature Human Behaviour, Journal Year: 2024, Volume and Issue: 8(6), P. 1076 - 1087

Published: March 21, 2024

Abstract Despite evidence indicating increased risk of psychiatric issues among COVID-19 survivors, questions persist about long-term mental health outcomes and the protective effect vaccination. Using UK Biobank data, three cohorts were constructed: SARS-CoV-2 infection ( n = 26,101), contemporary control with no 380,337) historical predating pandemic 390,621). Compared controls, infected participants had higher subsequent risks incident at 1 year (hazard ratio (HR): 1.54, 95% CI 1.42–1.67; P 1.70 × 10 −24 ; difference in incidence rate: 27.36, 21.16–34.10 per 1,000 person-years), including psychotic, mood, anxiety, alcohol use sleep disorders, prescriptions for antipsychotics, antidepressants, benzodiazepines, mood stabilizers opioids. Risks hospitalized individuals (2.17, 1.70–2.78; 5.80 −10 ) than those not (1.41, 1.30–1.53; 1.46 −16 ), reduced fully vaccinated people (0.97, 0.80–1.19; 0.799) compared non-vaccinated or partially (1.64, 1.49–1.79; 4.95 −26 ). Breakthrough infections showed similar diagnosis (0.91, 0.78–1.07; 0.278) but prescription (1.42, 1.00–2.02; 0.053) uninfected controls. Early identification treatment disorders especially severely affected unvaccinated, should be a priority management long COVID. With accumulation breakthrough post-pandemic era, findings highlight need continued optimization strategies to foster resilience prevent escalation subclinical symptoms severe disorders.

Language: Английский

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Psychosocial alterations during the COVID-19 pandemic and the global burden of anxiety and major depressive disorders in adolescents, 1990–2021: challenges in mental health amid socioeconomic disparities

World Journal of Pediatrics, Journal Year: 2024, Volume and Issue: 20(10), P. 1003 - 1016

Published: Aug. 20, 2024

Language: Английский

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