Religion, Spirituality May Build Resilience Against Depression by Toughening the Brain
JAMA Psychiatry
Importance
We
previously reported a 90% decreased risk in major depression, assessed
prospectively, in adult offspring of depressed probands who reported that
religion or spirituality was highly important to them. Frequency of church
attendance was not significantly related to depression risk. Our previous brain
imaging findings in adult offspring in these high-risk families also revealed
large expanses of cortical thinning across the lateral surface of the right
cerebral hemisphere.
Objective
To determine whether high-risk adults who reported high importance of religion or spirituality had thicker cortices than those who reported moderate or low importance of religion or spirituality and whether this effect varied by family risk status.
Design, Setting, and Participants
Longitudinal, retrospective cohort, familial study of 103 adults (aged 18-54 years) who were the second- or third-generation offspring of depressed (high familial risk) or nondepressed (low familiar risk) probands (first generation). Religious or spiritual importance and church attendance were assessed at 2 time points during 5 years, and cortical thickness was measured on anatomical images of the brain acquired with magnetic resonance imaging at the second time point.
Main Outcomes and Measures
Cortical thickness in the parietal regions by risk status.
Results
Importance of religion or spirituality, but not frequency of attendance, was associated with thicker cortices in the left and right parietal and occipital regions, the mesial frontal lobe of the right hemisphere, and the cuneus and precuneus in the left hemisphere, independent of familial risk. In addition, the effects of importance on cortical thickness were significantly stronger in the high-risk than in the low-risk group, particularly along the mesial wall of the left hemisphere, in the same region where we previously reported a significant thinner cortex associated with a familial risk of developing depressive illness. We note that these findings are correlational and therefore do not prove a causal association between importance and cortical thickness.
Conclusions and Relevance
A thicker cortex associated with a high importance of religion or spirituality may confer resilience to the development of depressive illness in individuals at high familial risk for major depression, possibly by expanding a cortical reserve that counters to some extent the vulnerability that cortical thinning poses for developing familial depressive illness.
Link: http://goo.gl/BwgpTm
The American Journal of Psychiatry
Prevalence of Diagnosed Depression in Adolescents With
History of Concussion
Journal of Adolescent Health
Link: http://goo.gl/1OorLu
JAMA Psychiatry
Objective
To determine whether high-risk adults who reported high importance of religion or spirituality had thicker cortices than those who reported moderate or low importance of religion or spirituality and whether this effect varied by family risk status.
Design, Setting, and Participants
Longitudinal, retrospective cohort, familial study of 103 adults (aged 18-54 years) who were the second- or third-generation offspring of depressed (high familial risk) or nondepressed (low familiar risk) probands (first generation). Religious or spiritual importance and church attendance were assessed at 2 time points during 5 years, and cortical thickness was measured on anatomical images of the brain acquired with magnetic resonance imaging at the second time point.
Main Outcomes and Measures
Cortical thickness in the parietal regions by risk status.
Results
Importance of religion or spirituality, but not frequency of attendance, was associated with thicker cortices in the left and right parietal and occipital regions, the mesial frontal lobe of the right hemisphere, and the cuneus and precuneus in the left hemisphere, independent of familial risk. In addition, the effects of importance on cortical thickness were significantly stronger in the high-risk than in the low-risk group, particularly along the mesial wall of the left hemisphere, in the same region where we previously reported a significant thinner cortex associated with a familial risk of developing depressive illness. We note that these findings are correlational and therefore do not prove a causal association between importance and cortical thickness.
Conclusions and Relevance
A thicker cortex associated with a high importance of religion or spirituality may confer resilience to the development of depressive illness in individuals at high familial risk for major depression, possibly by expanding a cortical reserve that counters to some extent the vulnerability that cortical thinning poses for developing familial depressive illness.
Link: http://goo.gl/BwgpTm
Microvascular Abnormality in Schizophrenia as Shown by Retinal Imaging
The American Journal of Psychiatry
Objective
Retinal
and cerebral microvessels are structurally and functionally homologous, but
unlike cerebral microvessels, retinal microvessels can be noninvasively
measured in vivo by retinal imaging. The authors tested the hypothesis that
individuals with schizophrenia exhibit microvascular abnormality and evaluated
the utility of retinal imaging as a tool for schizophrenia research.
Method
Participants were members of the Dunedin Study, a population-representative
cohort followed from birth with 95% retention. Study members underwent retinal
imaging at age 38. The authors assessed retinal arteriolar and venular caliber
for all members of the cohort, including individuals who developed
schizophrenia.
Results
The findings provide initial support for the hypothesis that individuals with schizophrenia show microvascular abnormality. Moreover, the results suggest that the same vascular mechanisms underlie subthreshold symptoms and clinical disorder and that these associations may begin early in life. These findings highlight the promise of retinal imaging as a tool for understanding the pathogenesis of schizophrenia.
Link: http://goo.gl/6yCvs2
FDA Medwatch
The MedWatch January 2014 Safety Labeling Changes posting includes 39 products with safety labeling changes to the following sections: BOXED WARNINGS, CONTRAINDICATIONS, WARNINGS, PRECAUTIONS, ADVERSE REACTIONS and PATIENT PACKAGE INSERT.
Link: http://goo.gl/xO7jSp
Results
Study
members who developed schizophrenia were distinguished by wider retinal
venules, suggesting microvascular abnormality reflective of insufficient brain
oxygen supply. Analyses that controlled for confounding health conditions
suggested that wider retinal venules are not simply an artifact of co-occurring
health problems in schizophrenia patients. Wider venules were also associated
with a dimensional measure of adult psychosis symptoms and with psychosis
symptoms reported in childhood.
Conclusions The findings provide initial support for the hypothesis that individuals with schizophrenia show microvascular abnormality. Moreover, the results suggest that the same vascular mechanisms underlie subthreshold symptoms and clinical disorder and that these associations may begin early in life. These findings highlight the promise of retinal imaging as a tool for understanding the pathogenesis of schizophrenia.
Link: http://goo.gl/6yCvs2
January 2014 Drug Safety Labeling Changes includes 23 products with revisions to Prescribing Information
FDA Medwatch
The MedWatch January 2014 Safety Labeling Changes posting includes 39 products with safety labeling changes to the following sections: BOXED WARNINGS, CONTRAINDICATIONS, WARNINGS, PRECAUTIONS, ADVERSE REACTIONS and PATIENT PACKAGE INSERT.
The "Summary Page" provides a listing of
product names and safety labeling sections revised.
Link: http://goo.gl/xO7jSp
Elevated Serum Pesticide Levels and Risk for Alzheimer Disease
JAMA Neurology
Importance
The
causes of late-onset Alzheimer disease (AD) are not yet understood but likely
include a combination of genetic, environmental, and lifestyle factors. Limited
epidemiological studies suggest that occupational pesticide exposures are
associated with AD. Previously, we reported that serum levels of
dichlorodiphenyldichloroethylene (DDE), the metabolite of the pesticide
dichlorodiphenyltrichloroethane (DDT), were elevated in a small number of
patients with AD (n=20).
Objective
To
evaluate the association between serum levels of DDE and AD and whether the
apolipoprotein E (APOE) genotype modifies the association.
Design, Setting, and Participants
A case-control study consisting of existing
samples from patients with AD and control participants from the Emory
University Alzheimer’s Disease Research Center and the University of Texas
Southwestern Medical School’s Alzheimer’s Disease Center. Serum levels of DDE
were measured in 79 control and 86 AD cases.
Main Outcomes and Measures
Serum DDE levels, AD diagnosis, severity of
AD measured by the Mini-Mental State Examination score, and interaction with
APOE4 status.
Results
Levels of
DDE were 3.8-fold higher in the serum of those with AD (mean [SEM], 2.64 [0.35]
ng/mg cholesterol) when compared with control participants (mean [SEM], 0.69
[0.1] ng/mg cholesterol; P < .001). The highest tertile of DDE levels was
associated with an odds ratio of 4.18 for increased risk for AD (95% CI,
2.54-5.82; P < .001) and lower Mini-Mental State Examination scores (−1.605;
range, −3.095 to −0.114; P < .0001). The Mini-Mental State Examination
scores in the highest tertile of DDE were −1.753 points lower in the
subpopulation carrying an APOE ε4 allele compared with those carrying an APOE
ε3 allele (P interaction = .04). Serum levels of DDE were highly correlated
with brain levels of DDE (ρ = 0.95). Exposure of human neuroblastoma cells to
DDT or DDE increased levels of amyloid precursor protein.
Conclusions and Relevance
Elevated serum DDE levels are associated with an increased risk for AD
and carriers of an APOE4 ε4 allele may be more susceptible to the effects of
DDE. Both DDT and DDE increase amyloid precursor protein levels, providing
mechanistic plausibility for the association of DDE exposure with AD.
Identifying people who have elevated levels of DDE and carry an APOE ε4 allele
may lead to early identification of some cases of AD.
Link: http://goo.gl/gzKrlz
The causes of late-onset Alzheimer disease (AD) are not yet understood but likely include a combination of genetic, environmental, and lifestyle factors. Limited epidemiological studies suggest that occupational pesticide exposures are associated with AD. Previously, we reported that serum levels of dichlorodiphenyldichloroethylene (DDE), the metabolite of the pesticide dichlorodiphenyltrichloroethane (DDT), were elevated in a small number of patients with AD (n=20).
To evaluate the association between serum levels of DDE and AD and whether the apolipoprotein E (APOE) genotype modifies the association.
Serum DDE levels, AD diagnosis, severity of AD measured by the Mini-Mental State Examination score, and interaction with APOE4 status.
Levels of DDE were 3.8-fold higher in the serum of those with AD (mean [SEM], 2.64 [0.35] ng/mg cholesterol) when compared with control participants (mean [SEM], 0.69 [0.1] ng/mg cholesterol; P < .001). The highest tertile of DDE levels was associated with an odds ratio of 4.18 for increased risk for AD (95% CI, 2.54-5.82; P < .001) and lower Mini-Mental State Examination scores (−1.605; range, −3.095 to −0.114; P < .0001). The Mini-Mental State Examination scores in the highest tertile of DDE were −1.753 points lower in the subpopulation carrying an APOE ε4 allele compared with those carrying an APOE ε3 allele (P interaction = .04). Serum levels of DDE were highly correlated with brain levels of DDE (ρ = 0.95). Exposure of human neuroblastoma cells to DDT or DDE increased levels of amyloid precursor protein.
Elevated serum DDE levels are associated with an increased risk for AD and carriers of an APOE4 ε4 allele may be more susceptible to the effects of DDE. Both DDT and DDE increase amyloid precursor protein levels, providing mechanistic plausibility for the association of DDE exposure with AD. Identifying people who have elevated levels of DDE and carry an APOE ε4 allele may lead to early identification of some cases of AD.
Prevalence of Diagnosed Depression in Adolescents With
History of Concussion
Journal of Adolescent Health
Purpose
Previous studies in adults have suggested concussion and
other brain injury presents a risk factor for depression. The goal of our study
was to analyze the association between previous concussion and current
depression diagnosis in a large nationally representative adolescent data set.
Methods
Retrospective cohort study using the National Survey of
Children's Health 2007–2008, a nationally representative survey conducted via
random digit dialing. Data were obtained by parental report. We included youth
12–17 years old without a current concussion (N = 36,060), and evaluated the
association between previous concussion (binary) and current depression
diagnosis (binary) using multiple logistic regression to control for age, sex,
parental mental health, and socioeconomic status.
Results
After controlling for age, sex, parental mental health,
and socioeconomic status, history of concussion was associated with a 3.3-fold
greater risk for depression diagnosis (95% CI: 2.0–5.5). Other factors
significantly associated with depression diagnosis included poor or fair
parental mental health (OR: 3.7, 95% CI: 2.8–4.9), and older age (15–17 years
vs. 12–14 years, OR: 1.4, 95% CI: 1.1–1.8). Sex of the subject was not
significantly related to depression diagnosis. Being above 200% of the poverty
level was associated with approximately a 50% decreased risk of depression
diagnosis (95% CI: 35%–70%).
Conclusions
History of concussion was associated with a higher
prevalence of diagnosed depression in a large nationally representative
adolescent data set. Clinicians should screen for depression in their
adolescent patients with concussion. Future studies should confirm this
association using prospective methodology and examine potential treatment
approaches.Link: http://goo.gl/1OorLu
Mitigation of Sociocommunicational Deficits of Autism Through Oxytocin-Induced Recovery of Medial Prefrontal Activity
JAMA Psychiatry
Importance
Sociocommunicational deficits make it difficult for individuals with
autism spectrum disorders (ASD) to understand communication content with
conflicting verbal and nonverbal information. Despite growing prospects for
oxytocin as a therapeutic agent for ASD, no direct neurobiological evidence
exists for oxytocin’s beneficial effects on this core symptom of ASD. This is
slowing clinical application of the neuropeptide.
Objective
To
directly examine whether oxytocin has beneficial effects on the
sociocommunicational deficits of ASD using both behavioral and neural measures.
Design, Setting, and Participants
At the University of Tokyo Hospital, we conducted a randomized, double-blind, placebo-controlled, within-subject–crossover, single-site experimental trial in which intranasal oxytocin and placebo were administered. A total of 40 highly functioning men with ASD participated and were randomized in the trial.
At the University of Tokyo Hospital, we conducted a randomized, double-blind, placebo-controlled, within-subject–crossover, single-site experimental trial in which intranasal oxytocin and placebo were administered. A total of 40 highly functioning men with ASD participated and were randomized in the trial.
Interventions
Single-dose intranasal administration of oxytocin (24 IU) and placebo.
Single-dose intranasal administration of oxytocin (24 IU) and placebo.
Main Outcomes and Measures
Using functional magnetic resonance imaging,
we examined effects of oxytocin on behavioral neural responses of the
participants to a social psychological task. In our previous case-control study
using the same psychological task, when making decisions about social
information with conflicting verbal and nonverbal contents, participants with
ASD made judgments based on nonverbal contents less frequently with longer time
and could not induce enough activation in the medial prefrontal cortex.
Therefore, our main outcomes and measures were the frequency of the nonverbal
information–based judgments (NVJs), the response time for NVJs, and brain
activity of the medial prefrontal cortex during NVJs.
Results
Intranasal
oxytocin enabled the participants to make NVJs more frequently (P = .03) with
shorter response time (P = .02). During the mitigated behavior, oxytocin
increased the originally diminished brain activity in the medial prefrontal
cortex (P < .001). Moreover, oxytocin enhanced functional coordination in
the area (P < .001), and the magnitude of these neural effects was
predictive of the behavioral effects (P ≤ .01).
Conclusions and Relevance
These findings provide the first neurobiological evidence for oxytocin’s beneficial effects on sociocommunicational deficits of ASD and give us the initial account for neurobiological mechanisms underlying any beneficial effects of the neuropeptide.
These findings provide the first neurobiological evidence for oxytocin’s beneficial effects on sociocommunicational deficits of ASD and give us the initial account for neurobiological mechanisms underlying any beneficial effects of the neuropeptide.
Link: http://goo.gl/mWFTOI
Study Finds That Persistent Internalizing Disorders May
Lead to Accelerated Aging
Molecular Psychiatry
There is evidence that persistent psychiatric disorders
lead to age-related disease and premature mortality. Telomere length has
emerged as a promising biomarker in studies that test the hypothesis that
internalizing psychiatric disorders are associated with accumulating cellular
damage. We tested the association between the persistence of internalizing
disorders (depression, generalized anxiety disorder and post-traumatic stress
disorder) and leukocyte telomere length (LTL) in the prospective longitudinal
Dunedin Study (n=1037). Analyses showed that the persistence of internalizing
disorders across repeated assessments from ages 11 to 38 years predicted
shorter LTL at age 38 years in a dose–response manner, specifically in men
(β=−0.137, 95% confidence interval (CI): −0.232, −0.042, P=0.005). This
association was not accounted for by alternative explanatory factors, including
childhood maltreatment, tobacco smoking, substance dependence, psychiatric
medication use, poor physical health or low socioeconomic status. Additional
analyses using DNA from blood collected at two time points (ages 26 and 38
years) showed that LTL erosion was accelerated among men who were diagnosed
with internalizing disorder in the interim (β=−0.111, 95% CI: −0.184, −0.037,
P=0.003). No significant associations were found among women in any analysis,
highlighting potential sex differences in internalizing-related telomere
biology. These findings point to a potential mechanism linking internalizing
disorders to accelerated biological aging in the first half of the life course,
particularly in men. Because internalizing disorders are treatable, the findings
suggest the hypothesis that treating psychiatric disorders in the first half of
the life course may reduce the population burden of age-related disease and
extend health expectancy.
