393 results on '"Maria A. Oquendo"'
Search Results
2. In vivo serotonin transporter and 1A receptor binding potential and ecological momentary assessment (EMA) of stress in major depression and suicidal behavior
- Author
-
Elizabeth A. Bartlett, Francesca Zanderigo, Barbara Stanley, Tse-Hwei Choo, Hanga C. Galfalvy, Spiro P. Pantazatos, M. Elizabeth Sublette, Jeffrey M. Miller, Maria A. Oquendo, and J. John Mann
- Subjects
Pharmacology ,Psychiatry and Mental health ,Neurology ,Pharmacology (medical) ,Neurology (clinical) ,Biological Psychiatry - Published
- 2023
3. A Multi-Site Study of Mental Disorders in the Mozambican Health Care System
- Author
-
Lidia Gouveia, Kathryn Lovero, Wilza Fumo, Afonso Mazine Tiago Fumo, Palmira Dos Santos, Ana Olga Mocumbi, Maria A. Oquendo, Jair J. Mari, Milton Wainberg, and Cristiane Duarte
- Subjects
Psychiatry and Mental health ,Health Policy ,Public Health, Environmental and Occupational Health ,Pshychiatric Mental Health - Abstract
BackgroundIn Mozambique, human and financial resources for public mental health services are extremely limited. Understanding the mental health needs of those seeking healthcare can inform efficient targeting of mental health services. We examined if the frequency of mental disorders in a health facility varied based on the level of specialization of such facility, from primary care without mental health specialists (PrCMH-), to those with mental health specialists (PrCMH+) and tertiary care (TerC), where both inpatient and outpatient mental health services are available.MethodsParticipants were adults seeking health or mental health services at six facilities (2 PrCMH+, 3 PrCMH-, and 1 TerC) in the cities of Maputo and Nampula in Mozambique. Mental disorders were assessed by the MINI International Neuropsychiatric Interview (MINI) 4.0.0. We compared the sociodemographic characteristics and MINI diagnoses across the three types of health facilities. Multiple logistic regression models determined the likelihood that a person seeking services at each type of facility would have any mental disorder, common mental disorders (CMD), severe mental disorders (SMD), substance use disorders (SUD), and moderate-to-high suicide risk, adjusting for sociodemographic factors. ResultsOf the 612 total participants, 52.6% (n=322) were positive for at least one mental disorder: 37.1% were positive for CMD, 28.9% for SMD, 13.2% for SUD, and 10.5% had suicide risk. Presence of any mental disorder was highest in TerC (62.5%) and lowest in PrCMH- (48.4%). Adjusting for sociodemographic covariates, participants in PrCMH+ were significantly more likely to have SMD (OR: 1.85, 95%CI: 1.10-3.11) and SUD (OR: 2.79, 95%CI: 1.31-5.94) than participants in PrCMH-; participants in TerC were more likely to have CMD (OR: 1.70, 95%CI: 1.01-2.87) and SUD (OR: 2.57, 95%CI: 1.14-5.79) than in PrCMH-. Suicide risk was the only condition that did not differ across facility types.ConclusionsAs anticipated, people with mental disorders were more likely to be cared for at facilities with mental health specialists. However, our study suggests there is a remarkably high frequency of mental disorders across different types of facilities within the Mozambican healthcare system. These results suggest a need to increase mental health services at the primary care level.
- Published
- 2022
4. Emotional contagion behavior in a group of young girls in a secondary school in Maputo, Mozambique
- Author
-
Lίdia Gouveia, Flávio Mandlate, Carolina Ziebold, Wilza Fumo, Dirceu Mabunda, Kathryn L Lovero, Afonso Mazine Tiago Fumo, Palmira dos Santos, António Pacheco Palha, Ana Olga Mocumbi, Maria A Oquendo, Milton L Wainberg, Cristiane S Duarte, and Jair J Mari
- Subjects
Psychiatry and Mental health - Abstract
Background: Emotional Contagion Behavior (ECB), the synchronized expression of emotional symptoms among members of a group, has been observed globally. In Mozambique, there have been numerous reports of ECB in recent years. Since 2010 several girls from a secondary school in Maputo City, Mozambique exhibited ECB which involved repeated fainting spells, sometimes including verbal aggression and threats to colleagues and teachers. We conducted a study to analyze sociodemographic and clinical characteristics associated with ECB. Methods: This cross-sectional study included 154 females aged from 16 to 24 years old. We considered emotional contagion behavior as repeated fainting spells, sometimes including verbal aggression and threats to others (colleagues and teachers). Participants responded to a sociodemographic questionnaire, the Beck Anxiety Scale, and the revised Eysenck Personality Questionnaire (EPQ-R). Bivariate and multivariate logistic regression models analyzed sociodemographic and clinical characteristics associated with EBC. Results: Among study participants, 57 presented ECB and 97 did not. The likelihood of ECB was higher among those with previous history of ECB (OR = 8.28, 95% CI [2.51, 27.30]; p ⩽ .001) and extroverted personality profile (OR = 1.15, 95% CI [1.01, 1.30]; p = .038). Having a romantic relationship was related to lower likelihood of having ECB (OR = 0.04, 95% CI [0.01, 0.19]; p = .001). Conclusions: These results suggest that ECB may repeat over time and be related to challenges pertaining to personality development, the presence of sexual life, and close relationships with peers faced by adolescent girls.
- Published
- 2022
5. Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study
- Author
-
Flavio M. Mandlate, M. Claire Greene, Luis F. Pereira, Maria Lidia Gouveia, Jair Jesus Mari, Francine Cournos, Cristiane S. Duarte, Maria A. Oquendo, Marcelo Feijó Mello, and Milton L. Wainberg
- Subjects
Psychiatry and Mental health - Abstract
Introduction Lower adherence to antiretroviral treatment (ART) has been found among people with HIV (PWH) who have comorbid mental disorders like depression and alcohol use in Sub-Saharan African. However, there has been less exploration with regards to other mental disorders. Methods This study assessed the association of multiple mental disorders and adherence to ART based on the data from primary/tertiary health care facilities in Maputo and Nampula, Mozambique. We administered a sociodemographic questionnaire, Mini International Neuropsychiatric Interview (MINI) Plus 4.0.0 adapted for use in Mozambique to assess mental conditions, and a 3-item self-report to measure ART adherence. Results 395 HIV-positive (self-report) participants on ART, with an average age of 36.7 years (SD = 9.8), and 30.4% were male. The most common mental disorders were major depressive disorder (27.34%) followed by psychosis (22.03%), suicidal ideation/behavior (15.44%), and alcohol-use disorder (8.35%). Higher odds of missing at least one dose in the last 30 days (OR = 1.45, 95% CI: 1.01, 2.10) were found in participants with any mental disorder compared to those without a mental disorder. The highest levels of non-adherence were observed among those with drug use disorders and panic disorder. Conclusions In Mozambique, PWH with any co-occurring mental conditions had a lower probability of ART adherence. Integrating comprehensive mental health assessment and treatment and ART adherence interventions tailored to PWH with co-occurring mental disorders is necessary to attain optimal ART adherence and reach the UNAIDS ART target.
- Published
- 2023
6. Twenty-six years of psychosocial interventions to reduce suicide risk in adolescents: Systematic review and meta-analysis
- Author
-
Liat, Itzhaky, Sara, Davaasambuu, Steven P, Ellis, Sebastian, Cisneros-Trujillo, Katrina, Hannett, Kelly, Scolaro, Barbara H, Stanley, J John, Mann, Milton L, Wainberg, Maria A, Oquendo, and M Elizabeth, Sublette
- Subjects
Risk ,Suicide Prevention ,Psychiatry and Mental health ,Clinical Psychology ,Treatment Outcome ,Adolescent ,Humans ,Suicide, Attempted ,Child ,Psychosocial Intervention ,Self-Injurious Behavior ,Suicidal Ideation - Abstract
During adolescence, suicide risk increases; effective treatments are needed to reduce risk.Databases were searched (1995-2020) for randomized controlled trials (RCTs) concerning psychosocial treatments for suicide prevention in adolescents (10-18 yrs). Data were extracted from the timepoint closest to 6 months. Cohen's ds were estimated for reducing suicidal ideation (SI), self-harming behaviors (SHB) excluding strictly non-suicidal self-injury, and suicide attempts (SA) and analyzed using generalized least square regression. Meta-analytic innovations included within-person correlations to reflect trait suicidality; annualization to control for exposure; estimated lifetime risk based on ages; and modeling inclusion/exclusion criteria. Alternate approaches included relative risk and comparison of intervention and control treatments to baseline.Of 30 RCTs, 6 assessing SHB (4 measuring SA), and 7 assessing SI demonstrated treatment effectiveness. Overall, interventions decreased SI (n = 25) with low effect size (d = 0.08, p = 0.01), non-significant after controlling for publication bias (d = 0.05, p = 0.1); interventions were non-significant for SHB (n = 25, d = 0.001, p = 0.97) or SA (n = 18, d = 0.03, p = 0.52). To prevent one SHB, the number needed to treat (NNT) was 45[26,156]; for SA, NNT=42[24,149]. Non-superiority may relate to effectiveness of control treatments. Thus, experimental and control treatments also were compared to baseline: both reduced SI (p 0.0001), and effectiveness improved for SHB (NNT=12) and SA (NNT=11).Study heterogeneity and inconsistent statistical reporting limited meta-analysis.Psychosocial interventions for suicide risk in adolescents showed little effectiveness compared with control treatments; suicide outcomes improved in both groups compared to baseline. Different approaches may be needed, including precision medicine methodologies and standardized statistical reporting criteria.
- Published
- 2022
7. Graph theory analysis of whole brain functional connectivity to assess disturbances associated with suicide attempts in bipolar disorder
- Author
-
Anjali Sankar, Dustin Scheinost, Danielle A. Goldman, Rebecca Drachman, Lejla Colic, Luca M. Villa, Jihoon A. Kim, Yarani Gonzalez, Imani Marcelo, Mei Shinomiya, Brian Pittman, Cheryl M. Lacadie, Maria A. Oquendo, R. Todd Constable, and Hilary P. Blumberg
- Subjects
Adult ,Bipolar Disorder ,Brain ,Prefrontal Cortex ,Suicide, Attempted ,Neurosciences. Biological psychiatry. Neuropsychiatry ,Magnetic Resonance Imaging ,Article ,Cellular and Molecular Neuroscience ,Psychiatry and Mental health ,Human behaviour ,Humans ,Biological Psychiatry ,RC321-571 - Abstract
Brain targets to lower the high risk of suicide in Bipolar Disorder (BD) are needed. Neuroimaging studies employing analyses dependent on regional assumptions could miss hubs of dysfunction critical to the pathophysiology of suicide behaviors and their prevention. This study applied intrinsic connectivity distribution (ICD), a whole brain graph‐theoretical approach, to identify hubs of functional connectivity (FC) disturbances associated with suicide attempts in BD. ICD, from functional magnetic resonance imaging data acquired while performing a task involving implicit emotion regulation processes important in BD and suicide behaviors, was compared across 40 adults with BD with prior suicide attempts (SAs), 49 with BD with no prior attempts (NSAs) and 51 healthy volunteers (HVs). Areas of significant group differences were used as seeds to identify regional FC differences and explore associations with suicide risk-related measures. ICD was significantly lower in SAs than in NSAs and HVs in bilateral ventromedial prefrontal cortex (vmPFC) and right anterior insula (RaIns). Seed connectivity revealed altered FC from vmPFC to bilateral anteromedial orbitofrontal cortex, left ventrolateral PFC (vlPFC) and cerebellum, and from RaIns to right vlPFC and temporopolar cortices. VmPFC and RaIns ICD were negatively associated with suicidal ideation severity, and vmPFC ICD with hopelessness and attempt lethality severity. The findings suggest that SAs with BD have vmPFC and RaIns hubs of dysfunction associated with altered FC to other ventral frontal, temporopolar and cerebellar cortices, and with suicidal ideation, hopelessness, and attempt lethality. These hubs may be targets for novel therapeutics to reduce suicide risk in BD.
- Published
- 2022
8. Suicidal behavior across a broad range of psychiatric disorders
- Author
-
Yingcheng E. Xu, Daniel A. Barron, Katherin Sudol, Sidney Zisook, and Maria A. Oquendo
- Subjects
Cellular and Molecular Neuroscience ,Psychiatry and Mental health ,Molecular Biology - Published
- 2023
9. In vivo serotonin 1A receptor hippocampal binding potential in depression and reported childhood adversity
- Author
-
Elizabeth A. Bartlett, Ashley A. Yttredahl, Maura Boldrini, Andrea E. Tyrer, Kathryn R. Hill, Mala R. Ananth, Matthew S. Milak, Maria A. Oquendo, J. John Mann, Christine DeLorenzo, and Ramin V. Parsey
- Subjects
Psychiatry and Mental health - Abstract
Background Reported childhood adversity (CA) is associated with development of depression in adulthood and predicts a more severe course of illness. Although elevated serotonin 1A receptor (5-HT1AR) binding potential, especially in the raphe nuclei, has been shown to be a trait associated with major depression, we did not replicate this finding in an independent sample using the partial agonist positron emission tomography tracer [11C]CUMI-101. Evidence suggests that CA can induce long-lasting changes in expression of 5-HT1AR, and thus, a history of CA may explain the disparate findings. Methods Following up on our initial report, 28 unmedicated participants in a current depressive episode (bipolar n = 16, unipolar n = 12) and 19 non-depressed healthy volunteers (HVs) underwent [11C]CUMI-101 imaging to quantify 5-HT1AR binding potential. Participants in a depressive episode were stratified into mild/moderate and severe CA groups via the Childhood Trauma Questionnaire. We hypothesized higher hippocampal and raphe nuclei 5-HT1AR with severe CA compared with mild/moderate CA and HVs. Results There was a group-by-region effect (p = 0.011) when considering HV, depressive episode mild/moderate CA, and depressive episode severe CA groups, driven by significantly higher hippocampal 5-HT1AR binding potential in participants in a depressive episode with severe CA relative to HVs (p = 0.019). Contrary to our hypothesis, no significant binding potential differences were detected in the raphe nuclei (p-values > 0.05). Conclusions With replication in larger samples, elevated hippocampal 5-HT1AR binding potential may serve as a promising biomarker through which to investigate the neurobiological link between CA and depression.
- Published
- 2023
10. Risk factors for pre-adolescent onset suicidal behavior in a high-risk sample of youth
- Author
-
Giovanna Porta, Jamie Zelazny, J. John Mann, Maria A. Oquendo, Nadine M. Melhem, Boris Birmaher, David A. Brent, and Barbara Stanley
- Subjects
Adult ,Adolescent ,Offspring ,Suicide, Attempted ,Article ,Suicidal Ideation ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Suicidal ideation ,Multinomial logistic regression ,First episode ,Mood Disorders ,business.industry ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Exact test ,Mood disorders ,Adolescent Behavior ,Suicidal behavior ,Female ,Analysis of variance ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
OBJECTIVE: To identify risk factors for preadolescent onset suicidal behavior compared with adolescent/young adult onset suicidal behavior in a longitudinal sample of youth with parental history of mood disorders. METHODS: The sample includes 545 youth who were age 21 years or less at the time of their baseline assessment. Participants underwent baseline and yearly study assessments. Observations were censored at the time point closest to the first episode of suicidal behavior for youth with suicidal behavior and at the time of last observation for youth without suicidal behavior. Youth were categorized into 3 groups: first onset of suicidal behavior before the age of 13 (n=32), first onset of suicidal behavior between the ages of 13–21 (n=51) and those without suicide related behaviors (n=462). ANOVA, Chi-square, Fisher’s exact test and multinomial regression were used to test the hypotheses. RESULTS: Significant predictors of preadolescent onset suicidal behavior were diagnosis of depressive disorder (RRR=11.41, p
- Published
- 2021
11. Partnerships in Research to Implement and Disseminate Sustainable and Scalable Evidence-Based Practices (PRIDE) in Mozambique
- Author
-
Jair de Jesus Mari, Jean-Marie Alves-Bradford, Jennifer J. Mootz, Melanie M. Wall, Andre Fiks Salem, Kathryn L. Lovero, Lidia Gouveia, Phuti Ngwepe, Francine Cournos, Dirceu Mabunda, Maria A. Oquendo, Andrew Medina-Marino, Andrea H. Marques, Marcelo Feijó de Mello, Milena Mello, Wilza Fumo, Milton L. Wainberg, Cristiane S. Duarte, Paulino Feliciano, Ana Olga Mocumbi, Myrna M. Weissman, Palmira Fortunato Dos Santos, Antonio Suleman, Zuleyha Cidav, and Charl Bezuidenhout
- Subjects
Mental Health Services ,Pride ,Evidence-based practice ,media_common.quotation_subject ,Primary health care ,Article ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Stepped care ,030212 general & internal medicine ,Dissemination ,Mozambique ,Randomized Controlled Trials as Topic ,media_common ,Community Health Workers ,business.industry ,Mental Disorders ,Closing (real estate) ,Public relations ,Mental health ,030227 psychiatry ,Psychiatry and Mental health ,Evidence-Based Practice ,Task shifting ,business - Abstract
BACKGROUND: Mental health conditions impose a major burden worldwide, especially in low- and middle-income countries (LMICs), where health specialists are scarce. A challenge to closing LMICs’ mental health treatment gap is determining the most cost-effective task-shifting pathway for delivering mental health services using evidence-based interventions (EBIs). This article discusses the protocol for the first study implementing comprehensive mental health services in LMICs. METHODS: In partnership with the Mozambican Ministry of Health, this cluster-randomized, hybrid implementation effectiveness type-2 trial will evaluate implementation, patient, and service outcomes of three task-shifting delivery pathways in 20 Mozambican districts (population 4.7 million). In pathway 1 (usual care), community health workers (CHWs) and primary care providers (PCPs) refer patients to district-level mental health clinics. In pathway 2 (screen, refer, and treat), CHWs screen and refer patients to PCPs for behavioral and pharmacological EBIs in community clinics. In pathway 3 (community mental health stepped care), CHWs screen patients and deliver behavioral EBIs in the community and refer medication management cases to PCPs in clinics. Mixed-methods process evaluation will be used to examine factors affecting pathway implementation, adoption, and sustainability. Clinical activities will occur without research team support. Ministry of Health personnel will coordinate training and supervision. RESULTS: The most cost-effective pathway will be scaled up in all districts for 12 months. NEXT STEPS: This novel study integrating comprehensive mental health services into primary care will inform a toolkit to help the Mozambican Ministry of Health scale up the most cost-effective pathway for mental health services and can be a template for other LMICs.
- Published
- 2021
12. Prevalence and correlates of suicidal behavior in primary care settings in Mozambique
- Author
-
Vasco F. J. Cumbe, Maria Nélia Manaca, Dana L. Atkins, Alberto Muanido, Leecreesha Hicks, Maria A. Oquendo, Jair de Jesus Mari, and Bradley H. Wagenaar
- Subjects
Adult ,Primary Health Care ,Suicide, Attempted ,Suicidal Ideation ,Psychiatry and Mental health ,Risk Factors ,Suicidal behavior ,Prevalence ,Suicide attempt ,Humans ,Female ,Suicidal plan ,Mozambique ,Primary health care - Abstract
Background This study assessed the prevalence of suicidal behavior and associated risk factors in public primary health care in Mozambique. Methods The Mini International Neuropsychiatric Interview was used to evaluate suicidal behavior among 502 adults attending three Primary Health Care (PHC) settings. Results In the past month, 13% (n = 63) of PHC attendees expressed suicidal ideation, 8% (n = 40) had made a suicide plan, 4% (n = 20) had made a suicide attempt, and 5% (n = 25) reported a lifetime suicide attempt. Females had 2.8-fold increased odds of suicide plan (95% CI: 1.5, 5.5) and 3.3-fold increased odds of suicide attempt in the past month (95% CI: 1.2, 9.1). Each 10-year increase in age was associated with 0.61-fold the odds of suicide plan (95% CI: 0.38, 0.98) and 0.09-fold the odds of suicide attempt (95% CI: 0.01, 0.69) in the past month. People living with HIV (PLWHA) had 2.2-fold increased adjusted odds of past month suicide attempt (CI: 1.1, 4.1). Conclusion Suicidal behaviors are common among adults attending PHC clinics in Mozambique. Screening and linkage to effective preventive interventions are urgently needed in PHC settings. Females, younger individuals, and PLWHA are at elevated risk for suicidal behavior in PHC.
- Published
- 2022
13. Structural brain measures linked to clinical phenotypes in major depression replicate across clinical centres
- Author
-
Maria A. Oquendo, Christos Davatzikos, Darsol Seok, Kristin A. Linn, Myrna M. Weissman, Nicholas C. Cullen, Yvette I. Sheline, Meichen Yu, Romain Duprat, Desmond J. Oathes, Irem Aselcioglu, Philip A. Cook, Tyler M. Moore, and Russell T. Shinohara
- Subjects
0301 basic medicine ,Cingulate cortex ,business.industry ,Precuneus ,Anhedonia ,medicine.disease ,Neuroticism ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Psychiatry and Mental health ,030104 developmental biology ,0302 clinical medicine ,medicine.anatomical_structure ,Frontal lobe ,Sexual abuse ,medicine ,Major depressive disorder ,medicine.symptom ,Big Five personality traits ,business ,Molecular Biology ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Abnormalities in brain structural measures, such as cortical thickness and subcortical volumes, are observed in patients with major depressive disorder (MDD) who also often show heterogeneous clinical features. This study seeks to identify the multivariate associations between structural phenotypes and specific clinical symptoms, a novel area of investigation. T1-weighted magnetic resonance imaging measures were obtained using 3 T scanners for 178 unmedicated depressed patients at four academic medical centres. Cortical thickness and subcortical volumes were determined for the depressed patients and patients' clinical presentation was characterized by 213 item-level clinical measures, which were grouped into several large, homogeneous categories by K-means clustering. The multivariate correlations between structural and cluster-level clinical-feature measures were examined using canonical correlation analysis (CCA) and confirmed with both 5-fold and leave-one-site-out cross-validation. Four broad types of clinical measures were detected based on clustering: an anxious misery composite (composed of item-level depression, anxiety, anhedonia, neuroticism and suicidality scores); positive personality traits (extraversion, openness, agreeableness and conscientiousness); reported history of physical/emotional trauma; and a reported history of sexual abuse. Responses on the item-level anxious misery measures were negatively associated with cortical thickness/subcortical volumes in the limbic system and frontal lobe; reported childhood history of physical/emotional trauma and sexual abuse measures were negatively correlated with entorhinal thickness and left hippocampal volume, respectively. In contrast, the positive traits measures were positively associated with hippocampal and amygdala volumes and cortical thickness of the highly-connected precuneus and cingulate cortex. Our findings suggest that structural brain measures may reflect neurobiological mechanisms underlying MDD features.
- Published
- 2021
14. Examining the relationship between gray matter volume and a continuous measure of bipolarity in unmedicated unipolar and bipolar depression
- Author
-
Harry Rubin-Falcone, Reuben Heyman-Kantor, Ainsley K. Burke, Jeffrey M. Miller, J. John Mann, Mina M. Rizk, Yashar Yousefzadeh Fard, Maria A. Oquendo, Francesca Zanderigo, Matthew S. Milak, M. Elizabeth Sublette, and Gregory M. Sullivan
- Subjects
medicine.medical_specialty ,Bipolar Disorder ,Brain Structure and Function ,Audiology ,computer.software_genre ,behavioral disciplines and activities ,Gray (unit) ,03 medical and health sciences ,0302 clinical medicine ,Voxel ,mental disorders ,Humans ,Medicine ,Bipolar disorder ,Gray Matter ,Major depressive episode ,Depression (differential diagnoses) ,Cerebral Cortex ,Depressive Disorder, Major ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Magnetic Resonance Imaging ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Major depressive disorder ,medicine.symptom ,business ,computer ,030217 neurology & neurosurgery - Abstract
It has been argued that unipolar major depressive disorder (MDD) and bipolar disorder (BD) exist on a continuous spectrum, given their overlapping symptomatology and genetic diatheses. The Bipolarity Index (BI) is a scale that considers bipolarity as a continuous construct and was developed to assess confidence in bipolar diagnosis. Here we investigated whether BI scores correlate with gray matter volume (GMV) in a sample of unmedicated unipolar and bipolar depressed individuals.158 subjects (139 with MDD, 19 with BD) in a major depressive episode at time of scan were assigned BI scores. T1-weighted Magnetic Resonance Imaging scans were obtained and processed with Voxel-Based Morphometry using SPM12 (CAT12 toolbox) to assess GMV. Regression was performed at the voxel level to identify clusters of voxels whose GMV was associated with BI score, (p0.001, family-wise error-corrected cluster-level p0.05), with age, sex and total intracranial volume as covariates.GMV was inversely correlated with BI score in four clusters located in left lateral occipital cortex, bilateral angular gyri and right frontal pole. Clusters were no longer significant after controlling for diagnosis. GMV was not correlated with BI score within the MDD cohort alone.Incomplete clinical data required use of a modified BI scale.BI scores were inversely correlated with GMV in unmedicated subjects with MDD and BD, but these correlations appeared driven by categorical diagnosis. Future work will examine other imaging modalities and focus on elements of the BI scale most likely to be related to brain structure and function.
- Published
- 2021
15. Relationships between inflammatory markers and suicide risk status in major depression
- Author
-
M. Elizabeth Sublette, Maria Luísa Figueira, Licínia Ganança, J. John Mann, Xinguo Ren, Maria A. Oquendo, Zahra Basseda, Hanga Galfalvy, Thomas B. Cooper, Sebastian Cisneros-Trujillo, and Repositório da Universidade de Lisboa
- Subjects
medicine.medical_specialty ,Suicide, Attempted ,Gastroenterology ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Biological Psychiatry ,Depression (differential diagnoses) ,Inflammation ,chemistry.chemical_classification ,Depressive Disorder, Major ,Suicide attempt ,Depression ,business.industry ,medicine.disease ,Eicosapentaenoic acid ,030227 psychiatry ,Suicide ,Psychiatry and Mental health ,Omega-3 polyunsaturated fatty acids (PUFA) ,chemistry ,Docosahexaenoic acid ,Cytokines ,Major depressive disorder ,Analysis of variance ,business ,Biomarkers ,030217 neurology & neurosurgery ,Polyunsaturated fatty acid - Abstract
© 2020 Elsevier Ltd. All rights reserved., Pro-inflammatory status has been implicated in depression and suicidal behaviors. Polyunsaturated fatty acids (PUFAs) and cytokines, two types of inflammatory biomarkers, have been associated with suicide, independent of depression severity. How these biomarkers relate to each other is less clear. We measured plasma phospholipid levels of arachidonic acid (AA%), docosahexaenoic acid (DHA%), and eicosapentaenoic acid (EPA%) as a percentage of total phospholipids, as well as serum interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis factor α (TNF-α), in 80 patients with major depressive disorder (MDD) and 24 healthy controls (HC). Individual PUFA and cytokine species were compared using ANOVA across four suicide risk-stratified groups: 1) highest-risk, recent (within 5 years) suicide attempters (n = 20); 2) high-risk, severe current suicidal ideators (having intent or plan) with no recent attempt history (n = 22); 3) low-risk, current non-ideators who were also lifetime non-attempters (n = 38); and 4) HC (n = 24). None of the participants were enrolled following an acute suicide attempt. Of biomarkers studied, only DHA% (p = 0.012) and IL-1β (p = 0.002) differed between groups. In post-hoc testing, DHA% was lower in attempters than ideators (p = 0.018) or MDD non-ideators (trend level, p = 0.073). IL-1β was lowest in attempters, differentiating them from ideators (p = 0.009) and HC (p = 0.004). Recent suicide attempt, one of the most powerful predictors of suicide risk, was also most closely tied to inflammatory indices in this study. Low DHA% as an indicator of suicide risk is consistent with previous reports; however, lower IL-1β was unexpected and may relate to acuity/chronicity of inflammation. There is a need for prospective studies of immune status with respect to suicidal behaviors., This work was supported by the American Foundation for Suicide Prevention (AFSP) [(PI: Sublette) 10/1/13 – 9/30/15], the Association for Research and Development of the School of Medicine, University of Lisbon (Ganança), and by the National Institutes of Health [5 R01 MH48514-20 (PI: Oquendo) 12/01/08-11/30/14] and [1 P50 MH090964-01A1 (PI: Mann) 7/19/13 – 6/30/18].
- Published
- 2021
16. PAULA J. CLAYTON, MD
- Author
-
Jane L. Pearson, Maria A. Oquendo, Kathy Shear, Myrna M. Weissman, Steve Zalcman, Chip Reynolds, Ray DePaulo, Katie A. Busch, Matt Rudorfer, Christine Moutier, Bob Hirschfield, John F. Greden, Sid Zisook, Murray B. Stein, John E. Rush, Jan Fawcett, Jill M. Harkavy-Friedman, Barry D. Lebowitz, Maria Kovacs, and Naomi M. Simon
- Subjects
Psychiatry and Mental health ,Clinical Psychology - Published
- 2021
17. Exploration of baseline and early changes in neurocognitive characteristics as predictors of treatment response to bupropion, sertraline, and placebo in the EMBARC clinical trial
- Author
-
Maria A. Oquendo, Daniel M. Alschuler, Myrna M. Weissman, Ramin V. Parsey, Christian A. Webb, Gerard E. Bruder, Patrick J. McGrath, Thomas J. Carmody, Pia Pechtel, Madhukar H. Trivedi, John G. Keilp, Melvin G. McInnis, Cristina Cusin, Crystal Cooper, Maurizio Fava, Diego A. Pizzagalli, Patricia J. Deldin, Ashleigh Rutherford, and Yuen-Siang Ang
- Subjects
Bupropion ,Sertraline ,medicine.medical_specialty ,business.industry ,Serotonin reuptake inhibitor ,medicine.disease ,Placebo ,Article ,030227 psychiatry ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Internal medicine ,medicine ,Major depressive disorder ,Verbal fluency test ,Antidepressant ,business ,Neurocognitive ,030217 neurology & neurosurgery ,Applied Psychology ,medicine.drug - Abstract
BackgroundTreatment for major depressive disorder (MDD) is imprecise and often involves trial-and-error to determine the most effective approach. To facilitate optimal treatment selection and inform timely adjustment, the current study investigated whether neurocognitive variables could predict an antidepressant response in a treatment-specific manner.MethodsIn the two-stage Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC) trial, outpatients with non-psychotic recurrent MDD were first randomized to an 8-week course of sertraline selective serotonin reuptake inhibitor or placebo. Behavioral measures of reward responsiveness, cognitive control, verbal fluency, psychomotor, and cognitive processing speeds were collected at baseline and week 1. Treatment responders then continued on another 8-week course of the same medication, whereas non-responders to sertraline or placebo were crossed-over under double-blinded conditions to bupropion noradrenaline/dopamine reuptake inhibitor or sertraline, respectively. Hamilton Rating for Depression scores were also assessed at baseline, weeks 8, and 16.ResultsGreater improvements in psychomotor and cognitive processing speeds within the first week, as well as better pretreatment performance in these domains, were specifically associated with higher likelihood of response to placebo. Moreover, better reward responsiveness, poorer cognitive control and greater verbal fluency were associated with greater likelihood of response to bupropion in patients who previously failed to respond to sertraline.ConclusionThese exploratory results warrant further scrutiny, but demonstrate that quick and non-invasive behavioral tests may have substantial clinical value in predicting antidepressant treatment response.
- Published
- 2020
18. Technology and implementation science to forge the future of evidence-based psychotherapies: the PRIDE scale-up study
- Author
-
Myrna M. Weissman, Palmira Fortunato Dos Santos, Cristiane S. Duarte, Marcelo Feijó de Mello, Bianca Kann, Terriann Nicholson, Maria A. Oquendo, Melissa Stockton, Milena Mello, Antonio Suleman, Milton L. Wainberg, Anibal Anube, Paulino Feliciano, Francine Cournos, Ana Olga Mocumbi, Rogerio Mulumba, M. Claire Greene, Phuti Ngwepe, David S. Mandell, Jair de Jesus Mari, Jean-Marie Alves-Bradford, Jennifer J. Mootz, Andre Fiks Salem, Kathryn L. Lovero, Dirceu Mabunda, Charl Bezuidenhout, Simone H Schriger, Wilza Fumo, Maria Lídia Gouveia, and Flavio Mandlate
- Subjects
Mental Health Services ,Technology ,Medical education ,Evidence-based practice ,Mental Disorders ,Attendance ,Qualitative property ,Certification ,Mental health ,Focus group ,Article ,Psychotherapy ,Psychiatry and Mental health ,Interim ,Workforce ,Humans ,Psychology ,Implementation Science - Abstract
ObjectiveTo report the interim results from the training of providers inevidence-based psychotherapies (EBPs) and use of mobile applications.Design and SettingThe Partnerships in Research to Implement and Disseminate Sustainable and Scalable Evidence (PRIDE) study is a cluster-randomised hybrid effectiveness-implementation trial comparing three delivery pathways for integrating comprehensive mental healthcare into primary care in Mozambique. Innovations include the use of EBPs and scaling-up of task-shifted mental health services using mobile applications.Main outcome measuresWe examined EBP training attendance, certification, knowledge and intentions to deliver each component. We collected qualitative data through rapid ethnography and focus groups. We tracked the use of the mobile applications to investigate early reach of a valid screening tool (Electronic Mental Wellness Tool) and the roll out of the EBPsParticipantsPsychiatric technicians and primary care providers trained in the EBPs.ResultsPRIDE has trained 110 EBP providers, supervisors and trainers and will train 279 community health workers in upcoming months. The trainings improved knowledge about the EBPs and trainees indicated strong intentions to deliver the EBP core components. Trained providers began using the mobile applications and appear to identify cases and provide appropriate treatment.ConclusionsThe future of EBPs requires implementation within existing systems of care with fidelity to their core evidence-based components. To sustainably address the vast mental health treatment gap globally, EBP implementation demands: expanding the mental health workforce by training existing human resources; sequential use of EBPs to comprehensively treat mental disorders and their comorbid presentations and leveraging digital screening and treatment applications.
- Published
- 2020
19. Rethinking 'Aggression' and Impulsivity in Bipolar Disorder: Risk, Clinical and Brain Circuitry Features
- Author
-
Rebecca Drachman, Lejla Colic, Anjali Sankar, Linda Spencer, Danielle A. Goldman, Luca M. Villa, Jihoon A. Kim, Maria A. Oquendo, Brian Pittman, and Hilary P. Blumberg
- Subjects
Adult ,Aggression ,Male ,Psychiatry and Mental health ,Clinical Psychology ,Bipolar Disorder ,Substance-Related Disorders ,Impulsive Behavior ,Brain ,Humans ,Female ,Gray Matter ,Article - Abstract
BACKGROUND: Elevated aggression and impulsivity are implicated in Bipolar Disorder (BD); however, relationships between these behavioral constructs have not been clarified, which can lead to misconceptions with negative consequences including stigma and adverse outcomes including suicide. The study aimed to clarify brain-based distinctions between the two constructs and their associations to risk factors, symptoms and suicide thoughts and behaviors. METHODS: Self-rated Brown-Goodwin Aggression (BGA) and Barratt Impulsiveness Scale (BIS) scores were compared between adults with BD (n=38, 74% female) and healthy controls (HC, n=29, 64% female). Relationships were examined between BGA and BIS with childhood trauma questionnaire (CTQ), mood, comorbidities, and magnetic resonance imaging gray matter volume (GMV) assessments. RESULTS: In BD, BGA and BIS total scores were both elevated and associated with childhood maltreatment (CM), particularly emotional CM, depression, substance use disorders (SUDs) and suicide attempts (SAs). BGA scores were increased by items corresponding to dysregulation of emotional and social behavior and associated with elevated mood states and suicide ideation and GMV decreases in bilateral orbitofrontal cortex and left posterior insula brain regions, previously associated with these behaviors and clinical features. BIS motor impulsiveness scores were associated with GMV decreases in anterior cingulate cortex implicated in mood and behavioral dyscontrol. LIMITATIONS: modest sample size, self-reports CONCLUSIONS: The findings suggest separable brain-based domains of dysfunction in BD of motor impulsiveness versus emotionally dysregulated feelings that are primarily self-directed. Both domains are associated with suicide behavior and modifiable risk factors of CM, depression and SUDs that could be targeted for prevention.
- Published
- 2022
20. Smaller left hippocampal subfield CA1 volume is associated with reported childhood physical and/or sexual abuse in major depression: A pilot study
- Author
-
Harry Rubin-Falcone, M. Elizabeth Sublette, R. Todd Ogden, Xuejing Lin, Ainsley K. Burke, Minlan Yuan, J. John Mann, Maria A. Oquendo, Mina M. Rizk, and Jeffrey M. Miller
- Subjects
Adult ,Hippocampus ,Pilot Projects ,Hippocampal formation ,Amygdala ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Child ,Depression (differential diagnoses) ,Retrospective Studies ,Depressive Disorder, Major ,Depression ,business.industry ,Sex Offenses ,Organ Size ,medicine.disease ,Magnetic Resonance Imaging ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,medicine.anatomical_structure ,nervous system ,Sexual abuse ,Major depressive disorder ,Sex offense ,business ,030217 neurology & neurosurgery ,Clinical psychology ,Psychopathology - Abstract
Background Smaller hippocampal volumes are reported in adults with major depressive disorder (MDD) and in reported childhood abuse. The hippocampus is a complex structure with distinct functional subfields. We sought to examine the effect of MDD diagnosis and childhood abuse on hippocampal subfields. Methods Forty-one MDD participants (17 reported abuse and 24 did not) and 46 healthy volunteers (HV) (2 reported abuse) underwent T1- weighted structural magnetic resonance imaging (MRI) and clinical characterization in a retrospective design. A subfield segmentation program was used to measure the whole and subfield hippocampal volumes. Linear mixed-effects models were fitted for group comparisons. Results No main effect of diagnosis interaction effect between diagnosis and subfield region was observed. However, a comparison of abused MDD vs. HVs showed a group by region interaction. A significant interaction between childhood abuse and region was observed. Effects were confined to the left side of the brain, and post hoc, exploratory region-specific tests indicated smaller left CA1 volume in abused MDD compared with non-abused MDD. In addition, smaller amygdala volume was found in all MDD compared with HVs. Limitations We did not have a sample of healthy volunteers with reported childhood abuse. Conclusions The diagnosis of pure MDD may not be sufficient to exert effects on hippocampal volumes, indicating the importance of taking into account childhood trauma in studies on psychopathological mechanisms. Left CA1 might be the hippocampal subfield most relevant to reported childhood abuse. Smaller amygdala volume may be related to MDD diagnosis independent of childhood abuse.
- Published
- 2020
21. Highly variable suicidal ideation: a phenotypic marker for stress induced suicide risk
- Author
-
Hanga Galfalvy, Maria A. Oquendo, Tse Hwei Choo, Raksha Kandlur, Jeffrey M. Miller, J. John Mann, M. Elizabeth Sublette, Barbara Stanley, and Ainsley K. Burke
- Subjects
0301 basic medicine ,Suicide, Attempted ,Impulsivity ,Article ,Suicidal Ideation ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Suicide Risk ,Molecular Biology ,Suicidal ideation ,Lability ,business.industry ,Aggression ,Stressor ,Psychiatry and Mental health ,Suicide ,030104 developmental biology ,Physical abuse ,Impulsive Behavior ,Trait ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Biomarkers ,Clinical psychology - Abstract
Suicidal behavior (SB) can be impulsive or methodical; violent or not; follow a stressor or no obvious precipitant. This study tested whether childhood trauma, affective lability, and aggressive and impulsive traits predicted greater SI variability. We also assessed whether affective lability, aggressive or impulsive traits explain childhood trauma’s effects on SI variability and whether those with highly variable SI respond to stressful events with increases in SI. Finally, we assessed variable SI’s trajectory over 2 years. Depressed participants (n = 51) had ecological momentary assessments (EMA) over 7 days at baseline, 3, 6, 12, 18, and 24 months. SI variability was assessed using the square Root of the Mean Square of Successive Deviations. Mixed Effects Models were fit as appropriate. Childhood trauma was associated with subsequent aggression. Physical abuse predicted both aggression and affective lability as well as SI variability, but not impulsivity. In two-predictor models, physical abuse’s effect on SI variability was no longer significant, when controlling for the effect of higher aggression and impulsivity. Those with high SI variability exhibited greater increases in SI after stressors compared with those with less variability. We did not find that SI variability changed over time, suggesting it might be trait-like, at least over 2 years. Variable SI predisposes to marked SI increases after stressful events and may be a trait increasing risk for impulsive SB, at least over 2 years.
- Published
- 2020
22. Detecting suicidal thoughts: The power of ecological momentary assessment
- Author
-
Liat Itzhaky, Maria A. Oquendo, J. John Mann, Tse-Hwei Choo, Barbara Stanley, Ilana Gratch, Hanga Galfalvy, and John G. Keilp
- Subjects
Adult ,Ecological Momentary Assessment ,Poison control ,Suicide prevention ,Occupational safety and health ,Suicidal Ideation ,03 medical and health sciences ,0302 clinical medicine ,Injury prevention ,Humans ,Medicine ,Suicidal ideation ,Retrospective Studies ,Depressive Disorder, Major ,Ecology ,business.industry ,Human factors and ergonomics ,Ideation ,medicine.disease ,humanities ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Major depressive disorder ,Smartphone ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND Researchers and clinicians have typically relied on retrospective reports to monitor suicidal thoughts and behaviors. Smartphone technology has made real-time monitoring of suicidal thoughts possible via mobile ecological momentary assessment (EMA). However, little is known about how information gleaned from EMA compares with that obtained by retrospective reports. The authors sought to compare suicidal ideation (SI) assessed over 1 week using EMA with a retrospective gold-standard interviewer-administered measure covering the same period. METHODS Fifty-one adults with major depressive disorder completed 1 week of EMA (6×/day) assessing SI. Following completion of EMA, participants completed an interviewer-administered Scale for Suicide Ideation (SSI) retrospectively assessing the same week. RESULTS SI severity assessed through EMA was positively correlated with scores on the retrospective SSI. However, 58% of participants reporting ideation with EMA denied any past-week ideation on the SSI. Participants who endorsed SI during EMA but not on the SSI were no less likely to have a history of suicidal behavior than those who reported SI in both formats. CONCLUSION EMA captures instances of suicidal thinking that go undetected through retrospective report and thereby may help us to identify an at-risk subgroup otherwise missed.
- Published
- 2020
23. Large-scale network dynamics in neural response to emotionally negative stimuli linked to serotonin 1A binding in major depressive disorder
- Author
-
Francesca Zanderigo, M. Elizabeth Sublette, Maria A. Oquendo, Jeffrey M. Miller, J. John Mann, Kevin N. Ochsner, Paul Sajda, Ainsley K. Burke, Harry Rubin Falcone, Noam Schneck, Barbara Stanley, and Tao Tu
- Subjects
0301 basic medicine ,Serotonin ,Hippocampus ,Inferior frontal gyrus ,Hippocampal formation ,Serotonergic ,behavioral disciplines and activities ,Amygdala ,Article ,Midbrain Raphe Nuclei ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,medicine ,Humans ,Molecular Biology ,Depressive Disorder, Major ,medicine.diagnostic_test ,Raphe ,business.industry ,Brain ,Magnetic Resonance Imaging ,Psychiatry and Mental health ,030104 developmental biology ,medicine.anatomical_structure ,nervous system ,Positron-Emission Tomography ,Receptor, Serotonin, 5-HT1A ,business ,Functional magnetic resonance imaging ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Serotonergic dysfunction is implicated in major depressive disorder (MDD), but the mechanisms of this relationship remain elusive. Serotonin 1A (5-HT1A) autoreceptors regulate brain-wide serotonin neuron firing and are positioned to assert large-scale effects on negative emotion. Here we investigated the relationship between raphe 5-HT1A binding and brain-wide network dynamics of negative emotion. 22 healthy-volunteers (HV) and 27 medication-free participants with MDD underwent positron emission tomography (PET) using [11C]CUMI-101 (CUMI) to quantify 5-HT1A binding in midbrain raphe nuclei and functional magnetic resonance imaging (fMRI) scanning during emotionally negative picture viewing. Causal connectivity across regions responsive to negative emotion was estimated in the fMRI data using a multivariate dynamical systems model. During negative picture viewing, MDD subjects demonstrated significant hippocampal inhibition of amygdala, basal-ganglia, thalamus, orbital frontal cortex, inferior frontal gyrus and dorsomedial prefrontal cortex (IFG, dmPFC). MDD-related connectivity was not associated with raphe 5-HT1A binding. However, greater hippocampal inhibition of amygdala, thalamus, IFG and dmPFC correlated with hippocampal 5-HT1A binding. Correlation between hippocampal 5-HT1A binding and the hippocampal inhibition network was specific to MDD but not HV. MDD and HV groups also differed with respect to the correlation between raphe and hippocampal 5-HT1A binding which was more pronounced in HV. These findings suggest that increased hippocampal network inhibition in MDD is linked to hippocampal serotonergic dysfunction which may in turn arise from disrupted linkage in raphe to hippocampus serotonergic circuitry.
- Published
- 2020
24. Sleep complaints are associated with increased suicide risk independently of psychiatric disorders: results from a national 3-year prospective study
- Author
-
Maria A. Oquendo, Philippe Courtet, Nicolas Hoertel, Michel Lejoyeux, Carlos Blanco, Pierre A. Geoffroy, Frédéric Limosin, Mark Olfson, and Hugo Peyre
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Suicide attempt ,business.industry ,Prevalence ,Sleep in non-human animals ,Structural equation modeling ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Psychiatry and Mental health ,030104 developmental biology ,0302 clinical medicine ,Increased risk ,medicine ,Suicide Risk ,Prospective cohort study ,Psychiatry ,business ,Molecular Biology ,030217 neurology & neurosurgery ,Psychopathology - Abstract
Prior research suggests that sleep disturbances are associated with increased risk of suicide. However, sleep disturbances are associated with a wide range of psychiatric disorders, and it is unknown whether this association is independent of psychopathology. In a large nationally representative prospective survey, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we used structural equation modeling to examine the shared and specific effects of three sleep complaints (i.e., trouble falling asleep, early morning awakening, and hypersomnia) on the 3-year occurrence of attempting suicide. Because psychiatric disorders increase the risk of suicide attempt almost exclusively through a general psychopathology factor representing their shared effect, covariates included that factor, prior history of suicide attempt, and a wide range of sociodemographic and clinical characteristics. The 3-year prevalence rate of suicide attempt was 0.6% (n = 241). Compared with participants who did not attempt suicide between the two waves, those who did reported significantly more frequently having trouble falling asleep (44.6% vs. 16.6%), early morning awakening (38.9% vs. 12.7%), and hypersomnia (35.0% vs. 10.7%). Following adjustments, effects of sleep complaints on this risk were significant and exerted almost exclusively through a general sleep complaints factor representing the shared effect across all sleep complaints. There were no residual associations of any individual sleep complaint with attempting suicide above that association. Sleep complaints are associated with an increased risk of attempting suicide independently of psychopathology, and should be included in suicide risk assessments as these symptoms may provide targets for reducing the risks of suicidal behaviors.
- Published
- 2020
25. Deficits of white matter axial diffusivity in bipolar disorder relative to major depressive disorder: No relationship to cerebral perfusion or body mass index
- Author
-
Harry Rubin-Falcone, Jonathan W. Stewart, J. John Mann, Maria A. Oquendo, Patrick J. McGrath, David J. Hellerstein, Francesca Zanderigo, M. Elizabeth Sublette, and Martin J. Lan
- Subjects
Adult ,Male ,medicine.medical_specialty ,Bipolar Disorder ,Internal capsule ,behavioral disciplines and activities ,Body Mass Index ,White matter ,03 medical and health sciences ,0302 clinical medicine ,Internal Capsule ,Internal medicine ,mental disorders ,medicine ,Humans ,Inferior longitudinal fasciculus ,Cerebral perfusion pressure ,Major depressive episode ,Biological Psychiatry ,Depressive Disorder, Major ,business.industry ,Superior longitudinal fasciculus ,Middle Aged ,medicine.disease ,White Matter ,030227 psychiatry ,Psychiatry and Mental health ,Diffusion Tensor Imaging ,medicine.anatomical_structure ,Cerebral blood flow ,Cerebrovascular Circulation ,Cardiology ,Major depressive disorder ,Female ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Objective To compare white matter integrity (WMI) in bipolar disorder (BD) relative to healthy volunteers (HVs) and major depressive disorder (MDD). To determine the relationship of bipolar-specific differences in WMI to cerebral perfusion, body mass index (BMI), and blood pressure as indices of cardiovascular function. Methods Thirty-two participants with BD, 44 with MDD, and 41 HV were recruited. All BD and MDD participants were in a major depressive episode, and all but 12 BD participants were medication-free. 64-direction diffusion tensor imaging (DTI) and arterial spin labeling (ASL) sequences were obtained. Tract-based spatial statistics (TBSS) on four DTI indices were employed to distinguish patterns of DTI in BD relative to HV and MDD groups. BMI, blood pressure, and medical histories were also obtained for the BD participants. Results A cluster of lower axial diffusivity (AD) was found in BD participants in comparison to the HVs in the left posterior thalamic radiation, superior longitudinal fasciculus, inferior longitudinal fasciculus, fronto-occipital fasciculus, and internal capsule. Mean AD in the significant cluster was not associated with cerebral blood flow (CBF) in the region as measured by ASL, and was not associated with BMI or blood pressure. A cluster of lower AD was also found in the BD group when compared to MDD that had spatial overlap with the HV comparison. Conclusions The results indicate a deficit of AD in BD when compared to MDD and HV groups. No association between AD values and either cerebral perfusion, BMI, or blood pressure was found in BD.
- Published
- 2019
26. Plasma testosterone levels and subsequent suicide attempts in males with bipolar disorder
- Author
-
Michael F. Grunebaum, J. John Mann, Leo Sher, Maria A. Oquendo, and M. Elizabeth Sublette
- Subjects
Male ,medicine.medical_specialty ,Bipolar Disorder ,business.industry ,Testosterone (patch) ,Suicide, Attempted ,medicine.disease ,Psychiatry and Mental health ,Endocrinology ,Risk Factors ,Internal medicine ,Medicine ,Humans ,Testosterone ,Bipolar disorder ,business - Published
- 2021
27. Data-driven analysis of kappa opioid receptor binding in major depressive disorder measured by positron emission tomography
- Author
-
Ashley Yttredahl, Maria A. Oquendo, Ansel T. Hillmer, Jeffrey M. Miller, Richard E. Carson, J. John Mann, and Kelly Smart
- Subjects
Adult ,medicine.medical_specialty ,Neurosciences. Biological psychiatry. Neuropsychiatry ,Molecular neuroscience ,κ-opioid receptor ,behavioral disciplines and activities ,Gyrus Cinguli ,Article ,Cellular and Molecular Neuroscience ,Rating scale ,Internal medicine ,medicine ,Humans ,Biological Psychiatry ,Depression (differential diagnoses) ,Depressive Disorder, Major ,medicine.diagnostic_test ,business.industry ,Depression ,Putamen ,Receptors, Opioid, kappa ,Brain ,medicine.disease ,Frontal Lobe ,Psychiatry and Mental health ,Frontal lobe ,Positron emission tomography ,Case-Control Studies ,Positron-Emission Tomography ,Cardiology ,Major depressive disorder ,Female ,business ,Insula ,RC321-571 - Abstract
Preclinical studies have implicated kappa opioid receptors (KORs) in stress responses and depression-related behaviors, but evidence from human studies is limited. Here we present results of a secondary analysis of data acquired using positron emission tomography (PET) with the KOR radiotracer [11C]GR103545 in 10 unmedicated, currently depressed individuals with major depressive disorder (MDD; 32.6 ± 6.5 years, 5 women) and 13 healthy volunteers (34.8 ± 10 years, 6 women). Independent component analysis was performed to identify spatial patterns of coherent variance in KOR binding (tracer volume of distribution, VT) across all subjects. Expression of each component was compared between groups and relationships to symptoms were explored using the 17-item Hamilton Depression Rating Scale (HDRS). Three components of variation in KOR availability across ROIs were identified, spatially characterized by [11C]GR103545 VT in (1) bilateral frontal lobe; (2) occipital and parietal cortices, right hippocampus, and putamen; and (3) right anterior cingulate, right superior frontal gyrus and insula, coupled to negative loading in left middle cingulate. In MDD patients, component 3 was negatively associated with symptom severity on the HDRS (r = −0.85, p = 0.0021). There were no group-wise differences in expression of any component between patients and controls. These preliminary findings suggest that KOR signaling in cortical regions relevant to depression, particularly right anterior cingulate, could reflect MDD pathophysiology.
- Published
- 2021
28. Serotonin Transporter Binding in Major Depressive Disorder: Impact of Serotonin System Anatomy
- Author
-
Elizabeth A. Bartlett, Francesca Zanderigo, Denise Shieh, Jeffrey Miller, Patrick Hurley, Harry Rubin-Falcone, Maria A. Oquendo, M. Elizabeth Sublette, R. Todd Ogden, and J. John Mann
- Subjects
Cellular and Molecular Neuroscience ,Psychiatry and Mental health ,mental disorders ,Molecular Biology - Abstract
Serotonin transporter (5-HTT) binding deficits are reported in major depressive disorder (MDD). However, most studies have not considered serotonin system anatomy when parcellating brain regions of interest (ROIs). We now investigate 5-HTT binding in MDD in two novel ways: (1) use of a 5-HTT tract-based analysis examining binding along serotonergic axons; and (2) using the Copenhagen University Hospital Neurobiology Research Unit (NRU) 5-HT Atlas, based on brain-wide binding patterns of multiple serotonin receptor types. [11C]DASB 5-HTT PET scans were obtained in 59 unmedicated participants with MDD in a current depressive episode and 32 healthy volunteers (HVs). Binding potential (BPP) was quantified with empirical Bayesian estimation in graphical analysis (EBEGA). Within the [11C]DASB tract, MDD showed significantly lower BPP compared with HVs (p=0.02). The BPP diagnosis difference varied by tract location at a trend-level (p=0.08), with MDD binding deficit strongest most proximal to brainstem raphe nuclei. NRU 5-HT Atlas ROIs showed trend-level lower BPPin MDD relative to HVs (p=0.06) and BPP diagnosis difference that varied by region (p=0.001). BPP was lower in MDD in 4/10 regions (p-values
- Published
- 2021
29. Neural predictors and effects of cognitive behavioral therapy for depression: the role of emotional reactivity and regulation - CORRIGENDUM
- Author
-
Harry Rubin-Falcone, Jochen Weber, Ronit Kishon, Kevin Ochsner, Lauren Delaparte, Bruce Doré, Sudha Raman, Bryan T. Denny, Maria A. Oquendo, J. John Mann, and Jeffrey M. Miller
- Subjects
Psychiatry and Mental health ,Cognitive Behavioral Therapy ,Depression ,Emotions ,Humans ,Applied Psychology - Published
- 2021
30. Primary familial basal ganglia calcification presented with depression and obsessive–compulsive symptoms: A case report
- Author
-
Maria Lídia Gouveia, Mohsin Sidat, Dirceu Mabunda, Vasco Cumbe, Maria A. Oquendo, and Jair de Jesus Mari
- Subjects
Psychiatry and Mental health ,medicine.medical_specialty ,Neurology ,business.industry ,General Neuroscience ,Medicine ,Basal ganglia calcification ,Neurology (clinical) ,General Medicine ,business ,Obsessive compulsive symptoms ,Dermatology ,Depression (differential diagnoses) - Published
- 2020
31. Examining raphe-amygdala structural connectivity as a biological predictor of SSRI response
- Author
-
Maria A. Oquendo, Crystal Cooper, Andrew LaBella, Melvin G. McInnis, Maurizio Fava, Madhukar H. Trivedi, Diego A. Pizzagalli, Benji T. Kurian, Myrna M. Weissman, Mengru Zhang, Chuan Huang, Rajapillai L. I. Pillai, Ramin V. Parsey, Patrick J. McGrath, Jie Yang, and Christine DeLorenzo
- Subjects
Adult ,Male ,Oncology ,medicine.medical_specialty ,Placebo ,Hippocampus ,behavioral disciplines and activities ,Amygdala ,Article ,03 medical and health sciences ,0302 clinical medicine ,Sertraline ,Internal medicine ,mental disorders ,Fractional anisotropy ,medicine ,Humans ,Depressive Disorder, Major ,Raphe ,business.industry ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Antidepressive Agents ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,medicine.anatomical_structure ,Anisotropy ,Raphe Nuclei ,Major depressive disorder ,Antidepressant ,Female ,business ,Raphe nuclei ,Selective Serotonin Reuptake Inhibitors ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background Our lab has previously found that structural integrity in tracts from the raphe nucleus (RN) to the amygdala, measured by fractional anisotropy (FA), predicts remission to selective serotonin reuptake inhibitors (SSRIs) in major depressive disorder (MDD). This could potentially serve as a biomarker for remission that can guide clinical decision-making. To enhance repeatability and reproducibility, we replicated our study in a larger, more representative multi-site sample. Methods 64 direction DTI was collected in 144 medication-free patients with MDD from the Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC) study. We performed probabilistic tractography between the RN and bilateral amygdala and hippocampus and calculated weighted FA in these tracts. Patients were treated with either sertraline or placebo, and their change in Hamilton Depression Rating Scale (HDRS) score reported. Pretreatment weighted FA was compared between remitters and nonremitters, and correlation between FA and percent change in HDRS score was assessed. Exploratory moderator and voxel analyses were also performed. Results Contrary to our hypotheses, FA was greater in nonremitters than in remitters in RN-left and right amygdala tracts (p = 0.02 and 0.01, respectively). Pretreatment FA between the raphe and left amygdala correlated with greater, not reduced, HDRS (r = 0.18, p = 0.04). This finding was found to be greater in the placebo group. Moderator and voxel analyses yielded no significant findings. Conclusions We found greater FA in nonremitters between the RN and amygdala than in remitters, and a correlation between FA and symptom worsening, particularly with placebo. These findings may help reveal more about the nature of MDD, as well as guide research methods involving placebo response.
- Published
- 2019
32. Discovery and replication of cerebral blood flow differences in major depressive disorder
- Author
-
Benji T. Kurian, Peiying Liu, Ramin V. Parsey, Patrick J. McGrath, Maurizio Fava, Thomas J. Carmody, Mary L. Phillips, Bruce D. Grannemann, Crystal Cooper, Jorge R. C. Almeida, Hanzhang Lu, Maria A. Oquendo, Thilo Deckersbach, Cherise Chin Fatt, Myrna M. Weissman, Elizabeth Bartlett, Madhukar H. Trivedi, Ashley Malchow, and Melvin G. McInnis
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Thalamus ,behavioral disciplines and activities ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Neuroimaging ,Internal medicine ,mental disorders ,medicine ,Molecular Biology ,Brain function ,business.industry ,Inferior parietal lobule ,medicine.disease ,Psychiatry and Mental health ,030104 developmental biology ,nervous system ,Cerebral blood flow ,Cardiology ,Major depressive disorder ,business ,Insula ,Perfusion ,030217 neurology & neurosurgery - Abstract
Major depressive disorder (MDD) is a serious, heterogeneous disorder accompanied by brain-related changes, many of which are still to be discovered or refined. Arterial spin labeling (ASL) is a neuroimaging technique used to measure cerebral blood flow (CBF; perfusion) to understand brain function and detect differences among groups. CBF differences have been detected in MDD, and may reveal biosignatures of disease-state. The current work aimed to discover and replicate differences in CBF between MDD participants and healthy controls (HC) as part of the EMBARC study. Participants underwent neuroimaging at baseline, prior to starting study medication, to investigate biosignatures in MDD. Relative CBF (rCBF) was calculated and compared between 106 MDD and 36 HC EMBARC participants (whole-brain Discovery); and 58 MDD EMBARC participants and 58 HC from the DLBS study (region-of-interest Replication). Both analyses revealed reduced rCBF in the right parahippocampus, thalamus, fusiform and middle temporal gyri, as well as the left and right insula, for those with MDD relative to HC. Both samples also revealed increased rCBF in MDD relative to HC in both the left and right inferior parietal lobule, including the supramarginal and angular gyri. Cingulate and prefrontal regions did not fully replicate. Lastly, significant associations were detected between rCBF in replicated regions and clinical measures of MDD chronicity. These results (1) provide reliable evidence for ASL in detecting differences in perfusion for multiple brain regions thought to be important in MDD, and (2) highlight the potential role of using perfusion as a biosignature of MDD.
- Published
- 2019
33. Prevalence of depression among patients with presumptive pulmonary tuberculosis in Rio de Janeiro, Brazil
- Author
-
Pedro da Silva Martins, Annika C. Sweetland, José Ricardo de Almeida França, Karina M de Castro-Silva, Anna Cristina Calçada Carvalho, Maria A. Oquendo, Afrânio Lineu Kritski, and Maria Tavares Cavalcanti
- Subjects
Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Tuberculosis ,lcsh:RC435-571 ,Cross-sectional study ,prevalence ,macromolecular substances ,environment and public health ,Article ,03 medical and health sciences ,0302 clinical medicine ,Pulmonary tuberculosis ,lcsh:Psychiatry ,Surveys and Questionnaires ,Internal medicine ,Prevalence ,Humans ,Medicine ,Major depressive episode ,Tuberculosis, Pulmonary ,Depression (differential diagnoses) ,Mini-international neuropsychiatric interview ,Depressive Disorder, Major ,Primary Health Care ,integumentary system ,Depression ,business.industry ,Middle Aged ,medicine.disease ,3. Good health ,030227 psychiatry ,Patient Health Questionnaire ,Psychiatry and Mental health ,Cross-Sectional Studies ,tuberculosis ,Socioeconomic Factors ,Female ,medicine.symptom ,business ,Brazil ,030217 neurology & neurosurgery - Abstract
Objective: To estimate the prevalence of major depressive episode (MDE) in patients with presumptive pulmonary tuberculosis (pre-PTB, defined by cough lasting ≥ 3 weeks) and compare it between patients with pulmonary tuberculosis (PTB) and without PTB. Methods: Patients with pre-PTB (n=260) were screened for depression using the Patient Health Questionnaire (PHQ-9). Those individuals with scores ≥ 10 were subsequently assessed with the depression module of the Mini International Neuropsychiatric Interview (MINI-Plus) to confirm diagnosis. Associations of categorical variables with PTB and MDE were calculated using the chi-square test and OR. Results: PTB was confirmed in 98 patients (37.7%). A high proportion of both groups (active PTB and no PTB) screened positive for depression (60.2 vs. 62.1%, respectively). Among 159 patients who screened positive for depression, a subset of 97 (61.0%) were further evaluated with the MINI-Plus; current MDE was confirmed in 54.6% (53/97). On univariate and multivariate analysis, female sex was the only factor associated with the diagnosis of current MDE (p = 0.04). Conclusion: The prevalence of MDE was high among individuals with prolonged respiratory symptoms, independent of PTB diagnosis. This is consistent with other studies of depression in primary care in Brazil.
- Published
- 2019
34. Reward related ventral striatal activity and differential response to sertraline versus placebo in depressed individuals
- Author
-
Mary L. Phillips, Thomas J. Carmody, Phillip Adams, Crystal Cooper, Thilo Deckersbach, Marisa Toups, Melvin G. McInnis, Madhukar H. Trivedi, Haris Aslam, Myrna M. Weissman, Henry W. Chase, Scott Peltier, Tsafrir Greenberg, Maria A. Oquendo, Jorge R. C. Almeida, Benji T. Kurian, Maurizio Fava, Jay C. Fournier, Ramin V. Parsey, Patrick J. McGrath, and Richelle Stiffler
- Subjects
0301 basic medicine ,Oncology ,Adult ,Male ,medicine.medical_specialty ,Placebo ,Article ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Reward system ,0302 clinical medicine ,Reward ,Internal medicine ,Sertraline ,medicine ,Humans ,Molecular Biology ,Depressive Disorder, Major ,business.industry ,Dopaminergic ,Ventral striatum ,Hamilton Rating Scale for Depression ,medicine.disease ,Antidepressive Agents ,Psychiatry and Mental health ,030104 developmental biology ,medicine.anatomical_structure ,Ventral Striatum ,Major depressive disorder ,Antidepressant ,Female ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Medications to treat major depressive disorder (MDD) are not equally effective across patients. Given that neural response to rewards is altered in MDD and given that reward-related circuitry is modulated by dopamine and serotonin, we examined, for the first time, whether reward-related neural activity moderated response to sertraline, an antidepressant medication that targets these neurotransmitters. 222 unmedicated adults with MDD randomized to receive sertraline (n=110) or placebo (n=112) in the EMBARC (Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care) study completed demographic and clinical assessments, and pre-treatment functional magnetic resonance imaging while performing a reward task. We tested whether an index of reward system function in the ventral striatum (VS), a key reward circuitry region, moderated differential response to sertraline versus placebo, assessed with the Hamilton Rating Scale for Depression over 8 weeks. We observed a significant moderation effect of the reward index, reflecting the temporal dynamics of VS activity, on Week-8 depression levels (Fs≥9.67,ps≤0.002). Specifically, VS responses that were abnormal with respect to predictions from reinforcement learning theory were associated with lower Week-8 depression symptoms in the sertraline versus placebo arms. Thus, a more abnormal pattern of pre-treatment VS dynamic response to reward expectancy (expected outcome value) and prediction error (difference between expected and actual outcome), likely reflecting serotonergic and dopaminergic deficits, was associated with better response to sertraline than placebo. Pre-treatment measures of reward-related VS activity may serve as objective neural markers to advance efforts to personalize interventions by guiding individual-level choice of antidepressant treatment. Trial Registration: NCT01407094; http://clinicaltrials.gov/show/NCT01407094
- Published
- 2019
35. Cortisol Stress Response and in Vivo PET Imaging of Human Brain Serotonin 1A Receptor Binding
- Author
-
J. John Mann, Maria A. Oquendo, Barbara Stanley, Louisa J. Steinberg, Hanga Galfalvy, Harry Rubin-Falcone, Eli Min, John G. Keilp, Jeffrey M. Miller, M. Elizabeth Sublette, Thomas B. Cooper, R. Todd Ogden, and Joshua A. Kaufman
- Subjects
Male ,Hydrocortisone ,Pyridines ,PET imaging ,Pain, Procedural ,Regular Research Articles ,Piperazines ,stress ,0302 clinical medicine ,Trier social stress test ,Pharmacology (medical) ,Carbon Radioisotopes ,Brain Mapping ,Catheter insertion ,Brain ,Middle Aged ,serotonin ,Psychiatry and Mental health ,Receptor, Serotonin, 5-HT1A ,Major depressive disorder ,5-HT1A receptor ,Female ,Psychological stressor ,Adult ,Cortisol secretion ,medicine.medical_specialty ,Adolescent ,Rest ,cortisol ,Serotonergic ,Catheterization ,Young Adult ,03 medical and health sciences ,Stress, Physiological ,Internal medicine ,medicine ,Humans ,Aged ,Pharmacology ,Depressive Disorder, Major ,business.industry ,medicine.disease ,030227 psychiatry ,Endocrinology ,Positron-Emission Tomography ,Serotonin ,Radiopharmaceuticals ,business ,Stress, Psychological ,030217 neurology & neurosurgery - Abstract
Background Abnormalities in the hypothalamic-pituitary-adrenal axis, serotonergic system, and stress response have been linked to the pathogenesis of major depressive disorder. State-dependent hyper-reactivity of the hypothalamic-pituitary-adrenal axis is seen in major depressive disorder, and higher binding to the serotonin 1A receptor is observed as a trait in both currently depressed and remitted untreated major depressive disorder. Here, we sought to examine whether a relationship exists between cortisol secretion in response to a stressor and serotonin 1A receptor binding throughout the brain, both in healthy controls and participants with major depressive disorder. Methods Research participants included 42 medication-free, depressed subjects and 31 healthy volunteers. Participants were exposed to either an acute, physical stressor (radial artery catheter insertion) or a psychological stressor (Trier Social Stress Test). Levels of serotonin 1A receptor binding on positron emission tomography with [11C]WAY-100635 were also obtained from all participants. The relationship between [11C]WAY-100635 binding and cortisol was examined using mixed linear effects models with group (major depressive disorder vs control), cortisol, brain region, and their interactions as fixed effects and subject as a random effect. Results We found a positive correlation between post-stress cortisol measures and serotonin 1A receptor ligand binding levels across multiple cortical and subcortical regions, independent of diagnosis and with both types of stress. The relationship between [11C]WAY-100635 binding and cortisol was homogenous across all a priori brain regions. In contrast, resting cortisol levels were negatively correlated with serotonin 1A receptor ligand binding levels independently of diagnosis, except in the RN. There was no significant difference in cortisol between major depressive disorder participants and healthy volunteers with either stressor. Similarly, there was no correlation between cortisol and depression severity in either stressor group. Conclusions This study suggests that there may be a common underlying mechanism that links abnormalities in the serotonin system and hypothalamic-pituitary-adrenal axis hyper-reactivity to stress. Future studies need to determine how hypothalamic-pituitary-adrenal axis dysfunction affects mood to increase the risk of suicide in major depression.
- Published
- 2019
36. Neurocognitive functioning in community youth with suicidal ideation: gender and pubertal effects
- Author
-
Maria A. Oquendo, Tami D. Benton, Monica E. Calkins, Raquel E. Gur, Ran Barzilay, Ruben C. Gur, Jason D. Jones, Rhonda C. Boyd, and Tyler M. Moore
- Subjects
Male ,Adolescent ,Article ,Suicidal Ideation ,Cohort Studies ,Thinking ,Executive Function ,Young Adult ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Risk Factors ,Rating scale ,medicine ,Humans ,Cognitive Dysfunction ,Effects of sleep deprivation on cognitive performance ,Child ,Suicidal ideation ,Philadelphia ,Psychiatric Status Rating Scales ,Psychopathology ,Cognition ,Adolescent Development ,030227 psychiatry ,Psychiatry and Mental health ,Logistic Models ,Female ,medicine.symptom ,Psychology ,Neurocognitive ,030217 neurology & neurosurgery ,Social cognitive theory ,Developmental psychopathology ,Clinical psychology - Abstract
BackgroundAlthough there are extensive data on clinical psychopathology in youth with suicidal ideation, data are lacking regarding their neurocognitive function.AimsTo characterise the cognitive profile of youth with suicidal ideation in a community sample and evaluate gender differences and pubertal status effects.MethodParticipants (N = 6151, age 11–21 years, 54.9% females) from the Philadelphia Neurodevelopmental Cohort, a non-help-seeking community sample, underwent detailed clinical evaluation. Cognitive phenotyping included executive functioning, episodic memory, complex reasoning and social cognitive functioning. We compared participants with suicidal ideation (N = 672) and without suicidal ideation (N = 5479). Regression models were employed to evaluate differences in cognitive performance and functional level, with gender and pubertal status as independent variables. Models controlled for lifetime depression or general psychopathology, and for covariates including age and socioeconomic status.ResultsYouth with suicidal ideation showed greater psychopathology, poorer level of function but better overall neurocognitive performance. Greater functional impairment was observed in females with suicidal ideation (suicidal ideation × gender interaction, t = 3.091, P = 0.002). Greater neurocognition was associated with suicidal ideation post-puberty (suicidal ideation × puberty interaction, t = 3.057, P = 0.002). Exploratory analyses of specific neurocognitive domains showed that suicidal ideation-associated cognitive superiority was more prominent in post-pubertal males compared with females (Cohen's d = 0.32 and d = 0.11, respectively) across all cognitive domains.ConclusionsSuicidal ideation was associated with poorer functioning yet better cognitive performance, especially in post-pubertal males, as measured by a comprehensive cognitive battery. Findings point to gender and pubertal-status specificity in the relationship between suicidal ideation, cognition and function in youth.Declaration of interestR.B. serves on the scientific board and reports stock ownership in ‘Taliaz Health’, with no conflict of interest relevant to this work. M.A.O. receives royalties for the commercial use of the Columbia-Suicide Severity Rating Scale from the Research Foundation for Mental Hygiene. Her family owns stock in Bristol-Myers Squibb. All other authors declare no potential conflict of interest.
- Published
- 2019
37. Resting‐state amplitude of low‐frequency fluctuation is associated with suicidal ideation
- Author
-
Mina M. Rizk, M. Elizabeth Sublette, John G. Keilp, Harry Rubin-Falcone, Maria A. Oquendo, Martin J. Lan, Spiro P. Pantazatos, J. John Mann, and Jeffrey M. Miller
- Subjects
Adult ,Male ,medicine.medical_specialty ,Brain activity and meditation ,Hippocampus ,Audiology ,Article ,Suicidal Ideation ,03 medical and health sciences ,0302 clinical medicine ,Thalamus ,Post-hoc analysis ,medicine ,Humans ,Major depressive episode ,Suicidal ideation ,Brain Mapping ,Depressive Disorder, Major ,Resting state fMRI ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Magnetic Resonance Imaging ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Major depressive disorder ,Female ,Caudate Nucleus ,medicine.symptom ,business ,Functional magnetic resonance imaging ,human activities ,030217 neurology & neurosurgery - Abstract
Background Identifying brain activity patterns that are associated with suicidal ideation (SI) may help to elucidate its pathogenesis and etiology. Suicide poses a significant public health problem, and SI is a risk factor for suicidal behavior. Methods Forty-one unmedicated adult participants in a major depressive episode (MDE), 26 with SI on the Beck Scale for Suicidal Ideation and 15 without SI, underwent resting-state functional magnetic resonance imaging scanning. Twenty-one healthy volunteers (HVs) were scanned for secondary analyses. Whole brain analysis of both amplitude of low-frequency fluctuations (ALFFs) and fractional ALFF was performed in MDE subjects to identify regions where activity was associated with SI. Results Subjects with SI had greater ALFF than those without SI in two clusters: one in the right hippocampus and one in the thalamus and caudate, bilaterally. Multi-voxel pattern analysis distinguished between those with and without SI. Post hoc analysis of the mean ALFF in the hippocampus cluster found it to be associated with a delayed recall on the Buschke memory task. Mean ALFF from the significant clusters was not associated with depression severity and did not differ between MDE and HV groups. Discussion These results indicate that SI is associated with altered resting-state brain activity. The pattern of elevated activity in the hippocampus may be related to how memories are processed.
- Published
- 2019
38. Neural predictors and effects of cognitive behavioral therapy for depression: the role of emotional reactivity and regulation
- Author
-
Maria A. Oquendo, Bruce P. Doré, J. John Mann, Harry Rubin-Falcone, Lauren Delaparte, Bryan T. Denny, Sudha Raman, Ronit Kishon, Jochen Weber, Kevin N. Ochsner, and Jeffrey M. Miller
- Subjects
Adult ,Male ,Adolescent ,medicine.medical_treatment ,Emotions ,Precuneus ,Hippocampus ,behavioral disciplines and activities ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Neural Pathways ,medicine ,Humans ,Reactivity (psychology) ,Applied Psychology ,Depressive Disorder, Major ,Neural correlates of consciousness ,Cognitive Behavioral Therapy ,medicine.diagnostic_test ,Autobiographical memory ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,030227 psychiatry ,Oxygen ,Cognitive behavioral therapy ,Psychiatry and Mental health ,Treatment Outcome ,medicine.anatomical_structure ,Major depressive disorder ,Female ,Psychology ,Functional magnetic resonance imaging ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
BackgroundCognitive behavioral therapy (CBT) is an effective treatment for many patients suffering from major depressive disorder (MDD), but predictors of treatment outcome are lacking, and little is known about its neural mechanisms. We recently identified longitudinal changes in neural correlates of conscious emotion regulation that scaled with clinical responses to CBT for MDD, using a negative autobiographical memory-based task.MethodsWe now examine the neural correlates of emotional reactivity and emotion regulation during viewing of emotionally salient images as predictors of treatment outcome with CBT for MDD, and the relationship between longitudinal change in functional magnetic resonance imaging (fMRI) responses and clinical outcomes. Thirty-two participants with current MDD underwent baseline MRI scanning followed by 14 sessions of CBT. The fMRI task measured emotional reactivity and emotion regulation on separate trials using standardized images from the International Affective Pictures System. Twenty-one participants completed post-treatment scanning. Last observation carried forward was used to estimate clinical outcome for non-completers.ResultsPre-treatment emotional reactivity Blood Oxygen Level-Dependent (BOLD) signal within hippocampus including CA1 predicted worse treatment outcome. In contrast, better treatment outcome was associated with increased down-regulation of BOLD activity during emotion regulation from time 1 to time 2 in precuneus, occipital cortex, and middle frontal gyrus.ConclusionsCBT may modulate the neural circuitry of emotion regulation. The neural correlates of emotional reactivity may be more strongly predictive of CBT outcome. The finding that treatment outcome was predicted by BOLD signal in CA1 may suggest overgeneralized memory as a negative prognostic factor in CBT outcome.
- Published
- 2019
39. Gray and white matter differences in adolescents and young adults with prior suicide attempts across bipolar and major depressive disorders
- Author
-
Maria A. Oquendo, Jennifer A.Y. Johnston, Siyan Fan, Linda Spencer, Anjali Sankar, Amanda Wallace, Brian Pittman, Fei Wang, Elizabeth Lippard, and Hilary P. Blumberg
- Subjects
Adult ,Male ,Bipolar Disorder ,Adolescent ,Prefrontal Cortex ,Uncinate fasciculus ,Suicide, Attempted ,Hippocampus ,behavioral disciplines and activities ,Article ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,mental disorders ,Fractional anisotropy ,medicine ,Humans ,Bipolar disorder ,Gray Matter ,Young adult ,Prefrontal cortex ,Depressive Disorder, Major ,Suicide attempt ,business.industry ,Brain ,Organ Size ,medicine.disease ,Magnetic Resonance Imaging ,White Matter ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Diffusion Magnetic Resonance Imaging ,Mood disorders ,Case-Control Studies ,Anisotropy ,Major depressive disorder ,Female ,business ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Background Findings regarding brain circuitry abnormalities in suicide attempters (SAs) converge across bipolar disorder (BD) and major depressive disorder (MDD), the most common disorders observed in suicides. These abnormalities appear to be present during adolescence/young adulthood when suicide rates increase steeply, and suicide is a leading cause of death in this age group. Identification of brain circuitry common to adolescent/young adult SAs with BD and MDD is important for generating widely effective early prevention strategies. We examined brain circuitry in SAs in adolescents/young adults across these two disorders. Methods Eighty-three participants (ages 14–25 years), 46 with BD (21 SAs) and 37 with MDD (19 SAs), underwent structural and diffusion-weighted magnetic resonance scanning. Whole-brain analyses compared gray matter (GM) volume and white matter (WM) fractional anisotropy (FA) between SAs and non-suicide attempters (NSAs) across and within BD and MDD (p Results Across and within BD and MDD, SAs showed differences compared to NSAs in ventral prefrontal cortex (PFC) GM volume and fronto-limbic (including uncinate fasciculus (UF)) WM FA. Exploratory analyses showed additional within-disorder differences for BD SAs in dorsolateral PFC (dlPFC) and hippocampus GM volume and UF FA, and for MDD SAs dorsomedial and dlPFC GM and dorsal frontal WM. However, there was no significant interaction between suicide attempt status and diagnosis. Limitations Modest sample size. Conclusions Common fronto-limbic gray and white matter alterations in adolescent/young adult SAs are potential targets for suicide prevention strategies across mood disorders. Preliminary findings of disorder-specific regional findings could suggest diagnostic-specific optimal targets may exist.
- Published
- 2019
40. Preliminary examination of gray and white matter structure and longitudinal structural changes in frontal systems associated with future suicide attempts in adolescents and young adults with mood disorders
- Author
-
Judah Weathers, Siyan Fan, Maria A. Oquendo, Susan Quatrano, Linda Spencer, Anjali Sankar, Elizabeth Lippard, Brian Pittman, Hilary P. Blumberg, and Jennifer A.Y. Johnston
- Subjects
Male ,Bipolar Disorder ,Internal capsule ,Adolescent ,Prefrontal Cortex ,Suicide, Attempted ,Gyrus Cinguli ,Article ,Suicidal Ideation ,White matter ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal Capsule ,Fractional anisotropy ,medicine ,Humans ,Gray Matter ,Young adult ,Depressive Disorder, Major ,Mood Disorders ,business.industry ,Targeted interventions ,medicine.disease ,Magnetic Resonance Imaging ,White Matter ,Frontal Lobe ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Cross-Sectional Studies ,Diffusion Tensor Imaging ,medicine.anatomical_structure ,Mood disorders ,Anisotropy ,Female ,business ,Gray (horse) ,030217 neurology & neurosurgery ,Clinical psychology ,Diffusion MRI - Abstract
BACKGROUND: Mood disorders are major risk factors for suicidal behavior. While cross-sectional studies implicate frontal systems, data to aid prediction of suicide-related behavior in mood disorders are limited. Longitudinal research on neuroanatomical mechanisms underlying suicide risk may assist in developing targeted interventions. Therefore, we conducted a preliminary study investigating baseline gray and white matter structure and longitudinal structural changes associated with future suicide attempts. METHODS: High-resolution structural magnetic resonance imaging, diffusion tensor imaging, and suicide-related behavioral assessment data for 46 adolescents and young adults with mood disorders [baseline age(mean)=18 years; 61% female] were collected at baseline and at follow-up (interval(mean)=3 years). Differences in baseline and longitudinal changes in gray matter volume and white matter fractional anisotropy in frontal systems that distinguished the participants who made future attempts from those who did not were investigated. RESULTS: Seventeen (37%) of participants attempted suicide within the follow-up period. Future attempters (those attempting suicide between their baseline and follow-up assessment), compared to those who did not, showed lower baseline ventral and rostral prefrontal gray matter volume and dorsomedial frontal, anterior limb of the internal capsule, and dorsal cingulum fractional anisotropy, as well as greater decreases over time in ventral and dorsal frontal fractional anisotropy (p
- Published
- 2019
41. The Concise Health Risk Tracking-Self Report: Psychometrics within a placebo-controlled antidepressant trial among depressed outpatients
- Author
-
Bruce D. Grannemann, Manish K. Jha, Madhukar H. Trivedi, Joseph M. Trombello, Aasia Ali, A. J. Rush, Thomas J. Carmody, Myrna M. Weissman, Melvin G. McInnis, Phil Adams, Ramin V. Parsey, Patrick J. McGrath, Michael O. Killian, Taryn L. Mayes, and Maria A. Oquendo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Psychometrics ,Placebo ,Article ,Suicidal Ideation ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Sertraline ,Outpatients ,medicine ,Humans ,Pharmacology (medical) ,Health risk ,Self report ,Psychiatric Status Rating Scales ,Pharmacology ,Depressive Disorder, Major ,business.industry ,Reproducibility of Results ,Middle Aged ,Antidepressive Agents ,030227 psychiatry ,Psychiatry and Mental health ,Physical therapy ,Antidepressant ,Female ,Self Report ,Tracking (education) ,business ,030217 neurology & neurosurgery - Abstract
Background/aims: While substantial prior research has evaluated the psychometric properties of the 12-item Concise Health Risk Tracking-Self Report (CHRT-SR12), a measure of suicide propensity and suicidal thoughts, no prior research has investigated its factor structure, sensitivity to change over time, and other psychometric properties in a placebo-controlled trial of antidepressant medication, nor determined whether symptoms change throughout treatment. Methods: Participants in the multi-site Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study ( n=278) provided data to evaluate the factor structure and sensitivity to change over time of the CHRT-SR12 through eight weeks of a clinical trial in which participants received either placebo or antidepressant medication (sertraline). Results/Outcomes: Factor analysis confirmed two factors: propensity (comprised of first-order factors including pessimism, helplessness, social support, and despair) and suicidal thoughts. Internal consistency (α’s ranged from 0.69–0.92) and external validity were both acceptable, with the total score and propensity factor scores significantly correlated with total scores and single-item suicidal-thoughts scores on the self-report Quick Inventory of Depressive Symptoms and the clinician-rated 17-item Hamilton Rating Scale for Depression. Through analyzing CHRT-SR12 changes over eight treatment weeks, the total score and both the factors decreased regardless of baseline suicidal thoughts. Change in clinician-rated suicidal thoughts was reflected by change in both the total score and propensity factor score. Conclusions/interpretation: These results confirm the reliability, validity, and applicability of the CHRT-SR12 to a placebo-controlled clinical trial of depressed outpatients receiving antidepressant medication.
- Published
- 2019
42. Resting regional brain activity correlates of verbal learning deficit in major depressive disorder
- Author
-
Holly Brandenburg, John G. Keilp, Martin Schain, W. Antonio Potter, Francesca Zanderigo, Ramin V. Parsey, J. John Mann, M. Elizabeth Sublette, Kevin M. Malone, Matthew S. Milak, Spiro P. Pantazatos, and Maria A. Oquendo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cerebellum ,Brain activity and meditation ,Rest ,Neuroscience (miscellaneous) ,Prefrontal Cortex ,Audiology ,Verbal learning ,Gyrus Cinguli ,behavioral disciplines and activities ,Amygdala ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,mental disorders ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Depressive Disorder, Major ,Memory Disorders ,Recall ,business.industry ,Cognition ,Middle Aged ,Verbal Learning ,medicine.disease ,030227 psychiatry ,Dorsolateral prefrontal cortex ,Psychiatry and Mental health ,medicine.anatomical_structure ,Positron-Emission Tomography ,Mental Recall ,Major depressive disorder ,Female ,business ,030217 neurology & neurosurgery - Abstract
Memory deficits are reported in major depressive disorder (MDD). Prefrontal cortical and mesiotemporal cortical (MTC)/subcortical regions are involved in the Buschke Selective Reminding Task (SRT), a verbal list-learning task. To determine whether depression-related changes in resting brain metabolism explain (in part) the deficits in SRT performance found in MDD, statistical correlation maps were calculated between SRT total recall score (TR) and relative regional cerebral metabolic rate for glucose (rCMRglu), measured by [18F]-flourodeoxyglucose (FDG) positron emission tomography (PET), in unmedicated, depressed MDD patients (N = 29). Subsequently, to explore hypothesized loss of top-down control in MDD, we compared the correlations between rCMRglu of SRT-relevant regions of the dorsolateral prefrontal cortex (dlPFC) and amygdala in a larger cohort of MDD (N = 60; 29 inclusive) versus healthy controls (HC) (N = 43). SRT performance of patients is on average 0.5 standard deviation below published normative mean. TR and rCMRglu positively correlate in bilateral dorsomedial PFC, dlPFC, dorsal anterior cingulate; negatively correlate in bilateral MTC/subcortical regions, and cerebellum. rCMRglu in dlPFC correlates negatively with that in amygdala in HC but not in MDD. Depression-related changes present in FDG-PET measured resting brain activity may be in part responsible for memory deficit found in MDD.
- Published
- 2019
43. Social and Psychiatric Factors of Suicidal Thoughts and Behaviors in Mozambican Adolescents
- Author
-
Amálio X. Come, Lillian Polanco-Roman, Palmira Fortunato dos Santos, Wilza Fumo, Rómulo Mutemba, Soumitra Pathare, Milton L. Wainberg, Maria A. Oquendo, Cristiane S. Duarte, Marcelo F. Mello, and Kathryn L. Lovero
- Subjects
Adult ,Suicide Prevention ,Young Adult ,Psychiatry and Mental health ,Cross-Sectional Studies ,Adolescent ,Risk Factors ,Developmental and Educational Psychology ,Humans ,Suicide, Attempted ,Child ,Mozambique ,Suicidal Ideation - Abstract
Globally, suicide is the second leading cause of death for youth ages 10-24 years, and more than 75% of all deaths by suicide occur in low- and middle-income countries (LMIC).
- Published
- 2022
44. The lack of meaningful association between depression severity measures and neurocognitive performance
- Author
-
Marianne Gorlyn, Sean P. Madden, Maria A. Oquendo, J. John Mann, Ainsley K. Burke, and John G. Keilp
- Subjects
Adult ,Male ,Severity of Illness Index ,Young Adult ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Rating scale ,Task Performance and Analysis ,Humans ,Medicine ,Cognitive Dysfunction ,Depression (differential diagnoses) ,Psychiatric Status Rating Scales ,Depressive Disorder, Major ,business.industry ,Beck Depression Inventory ,Neuropsychology ,Middle Aged ,Mental Status and Dementia Tests ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Mood ,Case-Control Studies ,Major depressive disorder ,Female ,Factor Analysis, Statistical ,business ,Neurocognitive ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Background Neurocognitive deficits are common in depression, but most prior studies have not found strong associations between standard measures of symptom severity and the extent of these neurocognitive deficits. Diagnostic heterogeneity, or the lack of specific questions about neurocognition in these measures, may be undermining these associations. Method Neuropsychological performance was assessed via 10 tasks in a sample of 262 unmedicated patients with Major Depressive Disorder (MDD) and compared to that in healthy volunteers (n = 140), then correlated with (1) standard measures of depression severity including the Hamilton Depression Rating Scale and Beck Depression Inventory, (2) previously established, factor-analytically derived symptom factors that characterize the heterogeneity of these scales, and (3) a separate measure of cognitive complaint (Cognitive Failures Questionnaire) that was included to address the absence of specific questions about cognition in standard rating scales. Results Neurocognitive performance in these unmedicated MDD patients was not significantly associated with either total scores on the depression severity measures, any of their derived symptom factors, or the degree of subjective cognitive complaint – which itself was most strongly associated with mood disturbance. Limitations Depressed patients with the most prominent neurovegetative symptoms may be underrepresented in this sample. Conclusions Neurocognitive deficits were only weakly associated with standard depression symptom ratings, and not captured by self-report ratings of cognitive complaint. Neurocognitive deficits appear to be a separate symptom dimension that cannot be inferred from overall depression severity and require their own assessment, given that they have prognostic value for functional outcomes, suicide risk, and differential therapeutics.
- Published
- 2018
45. Exploratory genome-wide association analysis of response to ketamine and a polygenic analysis of response to scopolamine in depression
- Author
-
Maura L. Furey, James W. Murrough, Matthew Grunebaum, Carlos A. Zarate, Wayne C. Drevets, Maria A. Oquendo, Nirmala Akula, J. John Mann, Kathleen R. Merikangas, Dennis S. Charney, Ioline D. Henter, Peixiong Yuan, Sanjay J. Mathew, Bashkim Kadriu, Yin Yao Shugart, Francis J. McMahon, Wei Guo, and Rodrigo Machado-Vieira
- Subjects
Oncology ,medicine.medical_specialty ,Genome-wide association study ,lcsh:RC321-571 ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Rating scale ,Internal medicine ,Medicine ,Bipolar disorder ,Major depressive episode ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Biological Psychiatry ,Depression (differential diagnoses) ,business.industry ,medicine.disease ,030227 psychiatry ,3. Good health ,Psychiatry and Mental health ,Mood disorders ,Antidepressant ,Major depressive disorder ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Growing evidence suggests that the glutamatergic modulator ketamine has rapid antidepressant effects in treatment-resistant depressed subjects. The anticholinergic agent scopolamine has also shown promise as a rapid-acting antidepressant. This study applied genome-wide markers to investigate the role of genetic variants in predicting acute antidepressant response to both agents. The ketamine-treated sample included 157 unrelated European subjects with major depressive disorder (MDD) or bipolar disorder (BD). The scopolamine-treated sample comprised 37 unrelated European subjects diagnosed with either MDD or BD who had a current Major Depressive Episode (MDE), and had failed at least two adequate treatment trials for depression. Change in Montgomery–Asberg Depression Rating Scale (MADRS) or the 17-item Hamilton Depression Rating Scale (HAM-D) scale scores at day 1 (24 h post-treatment) was considered the primary outcome. Here, we conduct pilot genome-wide association study (GWAS) analyses to identify potential markers of ketamine response and dissociative side effects. Polygenic risk score analysis of SNPs ranked by the strength of their association with ketamine response was then calculated in order to assess whether common genetic markers from the ketamine study could predict response to scopolamine. Findings require replication in larger samples in light of low power of analyses of these small samples. Neverthless, these data provide a promising illustration of our future potential to identify genetic variants underlying rapid treatment response in mood disorders and may ultimately guide individual patient treatment selection in the future.
- Published
- 2018
46. Neurocognitive performance predicts treatment outcome with cognitive behavioral therapy for major depressive disorder
- Author
-
Maria A. Oquendo, Allison V. Metts, J. John Mann, Jeffrey M. Miller, Ronit Kishon, and John G. Keilp
- Subjects
Adult ,Male ,medicine.medical_treatment ,Dysfunctional family ,behavioral disciplines and activities ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,mental disorders ,medicine ,Humans ,Negativism ,Biological Psychiatry ,Depression (differential diagnoses) ,Depressive Disorder, Major ,Cognitive Behavioral Therapy ,business.industry ,Beck Depression Inventory ,Neuropsychology ,Middle Aged ,Mental Status and Dementia Tests ,medicine.disease ,030227 psychiatry ,Cognitive behavioral therapy ,Psychiatry and Mental health ,Treatment Outcome ,Major depressive disorder ,Female ,business ,Neurocognitive ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
The current study examined the contribution of baseline neuropsychological functioning to the prediction of antidepressant outcome with cognitive behavioral therapy (CBT) for Major Depressive Disorder (MDD). We hypothesized that depressed participants who were more neurocognitively intact and had less rigid, negative thinking would respond better to CBT. Thirty-one MDD patients completed a comprehensive neuropsychological battery before initiation of CBT. A subgroup also completed a probabilistic reversal learning task. Depression severity was assessed with the Beck Depression Inventory (BDI); rigid, negative thinking was assessed with the Dysfunctional Attitudes Scale (DAS) and the Automatic Thoughts Questionnaire (ATQ) throughout treatment. Remitters were compared to non-remitters. Paradoxically, eventual remitters performed generally worse across the neuropsychological battery considered as a whole. Univariate testing showed a significant difference on only a single measure, the Continuous Performance Test d', when corrected for multiple comparisons. Baseline rigid, negative thinking did not predict treatment outcome. Results suggest that the structure of CBT may particularly benefit individuals with mild depression-related neurocognitive difficulties during a depressive episode. Further research is needed to examine these patient characteristics and their potential contribution to the mechanisms of CBT efficacy.
- Published
- 2018
47. If Suicide Were COVID-19
- Author
-
Alejandro Porras-Segovia, Maria A. Oquendo, Milton L. Wainberg, Enrique Baca-García, and Philippe Courtet
- Subjects
Suicide Prevention ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,MEDLINE ,Resource Allocation ,Health care rationing ,Cause of Death ,Preventive Health Services ,Epidemiology ,Humans ,Medicine ,Healthcare Disparities ,Intensive care medicine ,Cause of death ,Health Care Rationing ,Mortality, Premature ,SARS-CoV-2 ,business.industry ,COVID-19 ,Suicide ,Psychiatry and Mental health ,Premature death ,Communicable Disease Control ,Resource allocation ,business - Published
- 2021
48. Cerebrospinal fluid levels of monoamines among suicide attempters: A systematic review and random-effects meta-analysis
- Author
-
Jean-François Costemale-Lacoste, Maria A. Oquendo, Edourd Leaune, Hélène Cipel, Nicolas Hoertel, Carlos Blanco, Frédéric Limosin, Pierre Ellul, Hugo Peyre, CCSD, Accord Elsevier, Université Paris Cité - UFR Médecine [Santé] (UPCité UFR Médecine), Université Paris Cité (UPCité), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Corentin Celton [Issy-les-Moulineaux], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), National Institute on Drug Abuse [Bethesda] (NIDA), Perelman School of Medicine, University of Pennsylvania, AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier le Vinatier [Bron], GHU Paris Psychiatrie et Neurosciences, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), and Université de Paris - UFR Médecine [Santé] (UP Médecine)
- Subjects
Oncology ,medicine.medical_specialty ,Serotonin ,Dopamine ,[SDV]Life Sciences [q-bio] ,Suicide, Attempted ,Violence ,Serotonergic ,03 medical and health sciences ,0302 clinical medicine ,Cerebrospinal fluid ,Internal medicine ,medicine ,Suicide attempt ,Humans ,Biological Psychiatry ,business.industry ,Dopaminergic ,Homovanillic Acid ,Biomarker ,Hydroxyindoleacetic Acid ,030227 psychiatry ,3. Good health ,Noradrenalin ,[SDV] Life Sciences [q-bio] ,Psychiatry and Mental health ,Monoamine neurotransmitter ,Systematic review ,Meta-analysis ,Violent ,Biomarker (medicine) ,business ,030217 neurology & neurosurgery ,meta-Analysis - Abstract
International audience; Background: It remains unclear whether the dopaminergic and noradrenergic systems may be implied in suicide attempt risk. In addition, although the serotonergic system has been extensively studied, no formal meta-analysis has been performed to examine its association with suicide attempt.Methods: Using PRISMA methodology, we performed a systematic literature review and random-effects meta-analyses of the differences in cerebrospinal fluid (CSF) levels of 5-HIAA, HVA and MHPG between suicide attempters and individuals who never attempted suicide.Results: We identified 30 studies including 937 suicide attempters and 1128 non-attempters; 29 of them measured CSF levels of 5-HIAA, 22 measured CSF levels of HVA and 14 measured CSF levels of MHPG. CSF levels of 5-HIAA and HVA were significantly lower in suicide attempters than in non-attempters [SMD = -0.43 (95% CI: -0.71 to -0.15; p < 0.01) and SMD = -0.45 (95% CI: -0.72 to -0.19; p < 0.01), respectively]. We did not find a significant association between CSF MHPG levels and suicide attempt.Limitations: Our analyses relied on a limited number of studies of good quality and most studies included small sample sizes.Conclusion: Both serotonin and dopamine systems may play a role in suicide attempt risk. Our findings suggest that a silo approach to biomarkers should be phased out in favor of the study of multiple systems in parallel and in the same populations to progress in the identification of the biological components independently associated with suicide risk, with the goal of identifying new treatment targets and improving suicide risk prediction.
- Published
- 2021
49. Identifying challenges and recommendations for advancing global mental health implementation research: A key informant study of the National Institute of Mental Health Scale-Up Hubs
- Author
-
Laura Shields-Zeeman, Maria A. Oquendo, José Miguel Uribe-Restrepo, Jasmine Kalha, Ozge Sensoy Bahar, Carlos Gómez-Restrepo, Soumitra Pathare, Deepak Tugnawat, Juliana L. Restivo, Hesham M. Hamoda, Bradley H. Wagenaar, Sue E. Levkoff, Tamora A. Callands, John A. Naslund, Lakshmi Vijayakumar, Haja Wurie, Hongtu Chen, Ishmael Amarreh, Vikram Patel, Arjun Kapoor, Inge Petersen, Milton L. Wainberg, Fred M. Ssewamala, Jones Masiye, Lawrence S. Wissow, and Chifundo Zimba
- Subjects
Mental Health Services ,Medical education ,Mental Disorders ,Psychological intervention ,Capacity building ,General Medicine ,Global Health ,Mental health ,United States ,Article ,030227 psychiatry ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Global mental health ,Mental Health ,Workforce ,Sustainability ,Global health ,Humans ,Implementation research ,Psychology ,030217 neurology & neurosurgery ,General Psychology ,National Institute of Mental Health (U.S.) - Abstract
Objective This study explored perspectives of researchers working with the National Institute of Mental Health (NIMH) Scale-Up Hubs, consisting of research partnerships for scaling up mental health interventions in low- and middle-income countries (LMICs), to: 1) identify common barriers to conducting impactful research on the implementation of evidence-based mental health services; and 2) provide recommendations to overcome these implementation challenges. Methods A sequential qualitative approach was employed. First, an open-ended survey was distributed to the 10 Scale-Up Hubs and NIMH program staff asking informants to identify challenges in conducting mental health implementation research in LMICs. Second, survey findings guided an in-person workshop to generate implementation recommendations to inform the field. Results In total, 46 respondents completed surveys, and 101 researchers attended the workshop. The workshop produced implementation recommendations for low-resource settings: 1) identifying impact of research on policy and practice; 2) sustaining careers of early researchers in global mental health; 3) engaging policymakers and donors to value mental health research; 4) supporting the workforce for delivering evidence-based treatments for mental disorders; and 5) promoting sustainability of programs. Conclusions These findings can strengthen collaboration between researchers and key stakeholders, and highlight important targets for improving mental health implementation research in LMICs.
- Published
- 2020
50. Negative early life experiences as risk factors for suicidal behavior in bipolar disorders
- Author
-
Beny Lafer and Maria A. Oquendo
- Subjects
Psychiatry ,Bipolar Disorder ,business.industry ,RC435-571 ,Suicide, Attempted ,Early life ,Suicidal Ideation ,Psychiatry and Mental health ,Suicide ,Editorial ,Suicidal behavior ,Risk Factors ,Medicine ,Humans ,business ,Clinical psychology - Published
- 2020
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.