Comorbid Depressive Disorders Research Articles

Evaluation of serum zonulin and occludin levels in obsessive-compulsive disorder and the effect of major depressive disorder comorbidity

Evaluation of serum zonulin and occludin levels in obsessive-compulsive disorder and the effect of major depressive disorder comorbidity

Molecular mechanisms of Schisandra chinensis in treating depression-neuropathic pain comorbidity by network pharmacology and molecular docking analysis

This study utilized network pharmacology and docking analyses to explore a groundbreaking therapeutic approach for managing the neuropathic pain and depressive disorder (NP/DD) comorbidity. Schisandra chinensis (SC), a common Chinese medicine, has demonstrated numerous beneficial effects in treating neuropsychological disorders. The main objective of this study was to identify potential bioactive components of SC and investigate their interactions with relevant target genes associated with NP/DD. To gain insights into the underlying molecular mechanisms, GO and KEGG analyses were conducted. Furthermore, molecular docking analysis was employed to validate the therapeutic relevance of SC’s active ingredients. Seven bioactive components of SC, namely Longikaurin A, Deoxyharringtonine, Angeloylgomisin O, Schisandrin B, Gomisin A, Gomisin G, and Gomisin R, exhibited effectiveness in the treatment of NP/DD. From this list, the first five components were selected for further analysis. The analyses revealed a complex network of interactions between the targets of SC and NP/DD, providing valuable information about the molecular mechanisms involved in the treatment of NP/DD with SC. SC components demonstrated the ability to regulate pathways involving tumor necrosis factor (TNF), vascular endothelial growth factor (VEGF), and other growth hormones (GH). Overall, this study contributes to our understanding of the molecular mechanisms underlying the effects of SC in treating NP/DD. Further investigation is necessary to explore the therapeutic potential of SC as a viable strategy for NP/DD comorbidity. These findings lay a solid foundation for future research endeavors in this field, holding potential implications for the development of novel therapeutic interventions targeting NP/DD.

Comorbidity of depression and posttraumatic stress disorder: Outcomes from a randomized controlled trial of surf and hike therapies among service members.

Major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) are commonly comorbid mental health disorders. Exercise performed in the natural environment has shown promise in relieving symptoms of each disorder separately; however, the effectiveness has seldom been studied in comorbid populations. Data were derived from a randomized controlled trial of surf and hike therapy for active duty service members with MDD (N = 95). In this study, participants were grouped by comorbidity status (MDD, n = 37; MDD-PTSD, n = 58). Clinician-administered and self-reported measures were completed at preprogram, postprogram, and 3-month follow-up; a brief depression/anxiety measure was completed before and after each session. Multilevel modeling results showed clinically significant decreases in depression severity across participants from pre- to postprogram (p < .001) and within exercise sessions (p < .001), with no further change through follow-up. No significant differences emerged in depression severity change over time by comorbidity status, intervention condition, or their three-way interaction. Those with PTSD showed reductions in posttraumatic stress symptoms from pre- to postprogram (p < .001), which did not differ by intervention condition; gains were maintained at follow-up. Remission rates from MDD and PTSD diagnoses (if applicable) were significant from pre- to postprogram for both MDD-only and MDD-PTSD groups (p < .001). These improvements were maintained at 3 months. Both surf and hike therapies can improve MDD and PTSD symptoms, regardless of comorbidity status, suggesting utility of these interventions among service members with one or both disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Comorbidity of depression and posttraumatic stress disorder: Outcomes from a randomized controlled trial of surf and hike therapies among service members.

Major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) are commonly comorbid mental health disorders. Exercise performed in the natural environment has shown promise in relieving symptoms of each disorder separately; however, the effectiveness has seldom been studied in comorbid populations. Data were derived from a randomized controlled trial of surf and hike therapy for active duty service members with MDD (N = 95). In this study, participants were grouped by comorbidity status (MDD, n = 37; MDD-PTSD, n = 58). Clinician-administered and self-reported measures were completed at preprogram, postprogram, and 3-month follow-up; a brief depression/anxiety measure was completed before and after each session. Multilevel modeling results showed clinically significant decreases in depression severity across participants from pre- to postprogram (p < .001) and within exercise sessions (p < .001), with no further change through follow-up. No significant differences emerged in depression severity change over time by comorbidity status, intervention condition, or their three-way interaction. Those with PTSD showed reductions in posttraumatic stress symptoms from pre- to postprogram (p < .001), which did not differ by intervention condition; gains were maintained at follow-up. Remission rates from MDD and PTSD diagnoses (if applicable) were significant from pre- to postprogram for both MDD-only and MDD-PTSD groups (p < .001). These improvements were maintained at 3 months. Both surf and hike therapies can improve MDD and PTSD symptoms, regardless of comorbidity status, suggesting utility of these interventions among service members with one or both disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Potential correlations between asymmetric disruption of functional connectivity and metabolism in major depressive disorder

ObjectivePrevious research has suggested a connection between major depressive disorder (MDD) and certain comorbidities, including gastrointestinal issues, thyroid dysfunctions, and glycolipid metabolism abnormalities. However, the relationships between these factors and asymmetrical alterations in functional connectivity (FC) in adults with MDD remain unclear. MethodWe conducted a study on a cohort of 42 MDD patients and 42 healthy controls (HCs). Participants underwent comprehensive clinical assessments, including evaluations of blood lipids and thyroid hormone levels, as well as resting-state functional magnetic resonance imaging (Rs-fMRI) scans. Data analysis involved correlation analysis to compute the parameter of asymmetry (PAS) for the entire brain's functional connectome. We then examined the interrelationships between abnormal PAS regions in the brain, thyroid hormone levels, and blood lipid levels. ResultsThe third-generation ultra-sensitive thyroid stimulating hormone (TSH3UL) level was found to be significantly lower in MDD patients compared to HCs. The PAS score of the left inferior frontal gyrus (IFG) decreased, while the bilateral posterior cingulate cortex (Bi-PCC) PAS increased in MDD patients relative to HCs. Notably, the PAS score of the left IFG negatively correlated with both TSH and total cholesterol (CHOL) levels. However, these correlations lose significance after the Bonferroni correction. ConclusionMDD patients demonstrated abnormal asymmetry in resting-state FC (Rs-FC) within the fronto-limbic system, which may be associated with CHOL and thyroid hormone levels.

Examining Depression among Breast Cancer Survivors in Nigeria: A Scoping Review

Background: Depression is one of the major mental health problems that hinder recovery of breast cancer patients. Comorbidity of depressive disorder and breast cancer is a complicated medical condition globally. This study examined depression among breast cancer survivors in Nigeria. Methods: This study used a scoping review approach to explore four databases, which include Google Scholar, PubMed, Medline and Scopus. The search produced 50 records using formulated search terms formulated which are relevant to the topics. Of the 50 records selected, 42 articles that did not meet eligible requirements were removed, and 8 records were included. Results: this study revealed that depression is one of the psychological problems that patients with breast cancer experience in Nigeria. In addition, this review revealed that psychological interventions such as cognitive behavioural therapy (CBT) and pilot cognitive restructuring are effective in reducing the depressive symptoms among breast cancer patients in Nigeria. Conclusion: Based on the published peer reviewed articles, depression is major mental health problem among breast cancer patients in Nigeria, and CBT and psychoeducation have been found to be effective treating depression symptoms in Nigeria. However, more studies are needed in the northern parts of the country since most of the review studies were done in the southern parts of the country.

Efficacy of an Internet- and Mobile-Based Intervention for Subclinical Anxiety and Depression (ICare Prevent) with Two Guidance Formats: Results from a Three-Armed Randomized Controlled Trial

Introduction: Limited research exists on intervention efficacy for comorbid subclinical anxiety and depressive disorders, despite their common co-occurrence. Internet- and mobile-based interventions (IMIs) are promising to reach individuals facing subclinical symptoms. Objective: This study aimed to evaluate the efficacy of a transdiagnostic and self-tailored IMI in reducing subclinical anxiety and depressive symptom severity with either individualized (IG-IMI) or automated (AG-IMI) guidance compared to a waitlist control group with care-as-usual access (WLC). Methods: Participants included 566 adults with subclinical anxiety (GAD-7 ≥ 5) and/or depressive (CES-D ≥16) symptoms, who did not meet criteria for a full-syndrome depressive or anxiety disorder. In a three-arm randomized clinical trial, participants were randomized to a cognitive behavioral 7-session IMI plus booster session with IG-IMI (n = 186) or AG-IMI (n = 189) or WLC (n = 191). Primary outcomes included observer-rated anxiety (HAM-A) and depressive (QIDS) symptom severity 8 weeks after randomization assessed by blinded raters via telephone. Follow-up outcomes at 6 and 12 months are reported. Results: Symptom severity was significantly lower with small to medium effects in IG-IMI (anxiety: d = 0.45, depression: d = 0.43) and AG-IMI (anxiety: d = 0.31, depression: d = 0.32) compared to WLC. No significant differences emerged between guidance formats in primary outcomes. There was a significant effect in HAM-A after 6 months favoring AG-IMI. On average, participants completed 85.38% of IG-IMI and 77.38% of AG-IMI. Conclusions: A transdiagnostic, self-tailored IMI can reduce subclinical anxiety and depressive symptom severity, but 12-month long-term effects were absent. Automated guidance holds promise for enhancing the scalability of IMIs in broad prevention initiatives.

Comorbidity of anxiety and depression disorder among clinical referral patients: a longitudinal study based on network analysis

Comorbidity of anxiety and depression disorder among clinical referral patients: a longitudinal study based on network analysis

Epistasis in neurotransmitter receptors linked to posttraumatic stress disorder and major depressive disorder comorbidity in traumatized Chinese.

Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) comorbidity occurs through exposure to trauma with genetic susceptibility. Neuropeptide-Y (NPY) and dopamine are neurotransmitters associated with anxiety and stress-related psychiatry through receptors. We attempted to explore the genetic association between two neurotransmitter receptor systems and the PTSD-MDD comorbidity. Four groups were identified using latent profile analysis (LPA) to examine the patterns of PTSD and MDD comorbidity among survivors exposed to earthquake-related trauma: low symptoms, predominantly depression, predominantly PTSD, and PTSD-MDD comorbidity. NPY2R (rs4425326), NPY5R (rs11724320), DRD2 (rs1079597), and DRD3 (rs6280) were genotyped from 1,140 Chinese participants exposed to earthquake-related trauma. Main, gene-environment interaction (G × E), and gene-gene interaction (G × G) effects for low symptoms, predominantly depression, and predominantly PTSD were tested using a multinomial logistic model with PTSD-MDD comorbidity as a reference. The results demonstrated that compared to PTSD-MDD comorbidity, epistasis (G × G) NPY2R-DRD2 (rs4425326 × rs1079597) affects low symptoms (β = -0.66, OR = 0.52 [95% CI: 0.32-0.84], p = 0.008, pperm = 0.008) and predominantly PTSD (β = -0.56, OR = 0.57 [95% CI: 0.34-0.97], p = 0.037, pperm = 0.039), while NPY2R-DRD3 (rs4425326 × rs6280) impacts low symptoms (β = 0.82, OR = 2.27 [95% CI: 1.26-4.10], p = 0.006, pperm = 0.005) and predominantly depression (β = 1.08, R = 2.95 [95% CI: 1.55-5.62], p = 0.001, pperm = 0.001). The two G × G effects are independent. NPY and dopamine receptor genes are related to the genetic etiology of PTSD-MDD comorbidity, whose specific mechanisms can be studied at multiple levels.

ЭПИДЕМИОЛОГИЧЕСКИЕ АСПЕКТЫ НАРУШЕНИЙ МЕНТАЛЬНОГО ЗДОРОВЬЯ – ОТ ПРЕДИКТОРОВ К СЛЕДСТВИЮ

Introduction. Due to the high social significance of mental health disorders, the study of the spread and degree of influence of modifiable predictors of depressive psychoemotional status can contribute to the development of new approaches to active prevention. The purpose of the study. To study the epidemiological characteristics of mental health disorders and identify key predictors among students. Methods. To conduct the study, epidemiological diagnostic methods were used, such as: retrospective epidemiological analysis, descriptive and evaluative methods, as well as statistical methods, methods of epidemiological diagnostics using methods of clinical epidemiology and statistical analysis were used. Results. There was a moderate long-term epidemic trend towards an increase in the incidence of mental disorders (an increase rate of 3.68%) and a high long-term average (164.44+1.72о/оооо). The risk area is determined on the basis of the characteristic pronounced tendency to growth and an increased level of relative epidemiological risk: Minsk region, Minsk, Vitebsk and Mogilev regions (Tpr = 6.56%, 9.99%, 15.21%, and 15.57%, respectively. Consequently, the risks were: in Minsk – 0.77, in Vitebsk and Mogilev regions – 0.78 and 0.86, respectively). The result of our own original research was the identification of a depressive state in 59.25% of cases and generalized anxiety disorder – in 64.1% of cases. An aggravating circumstance is the fact of comorbidity in more than 80% of cases. When studying the epidemiological characteristics of these disorders, significant predictors were identified that increased the chance of developing a state by 2.5-11.5 times. Conclusion. The high levels of prevalence and comorbidity of depressive psychoemotional status and anxiety disorder characterize the general epidemiological situation within the mental health of students as unfavorable and require the development of preventive measures.

Cognitive-behavioral statuses in depression and internet gaming disorder of adolescents: A transdiagnostic approach.

To investigate the comorbidity of adolescent depression and Internet gaming disorder (IGD) and their shared and unique cognitive-behavioral factors (i.e., self-esteem, dysfunctional attitudes, hopelessness, and coping), a large-scale school-based survey was conducted among 3147 Chinese secondary school students in Hong Kong. Probable depression and IGD were screened using the Centre for Epidemiological Studies-Depression Scale and DSM-5 IGD checklist, respectively. Multinomial logistic regression was performed to identify the associations between different condition statuses and cognitive-behavioral factors. Four groups were identified, including comorbidity group (having probable depression and IGD), IGD group (having probable IGD alone), depression group (probable depression alone), and healthy group (neither condition). Comorbidity group showed the worst cognitive-behavioral statuses, followed by depression group and then IGD group. Compared with healthy group, those with lower self-esteem and higher hopelessness and dysfunctional attitudes were more likely to be classified into depression group and comorbidity group, while maladaptive coping was positively associated with all three disorder groups. The results suggest that depression and IGD may share common cognitive-behavioral mechanisms (e.g., maladaptive coping) but also own their uniqueness regarding specific factors (e.g., hopelessness and self-esteem). A transdiagnostic intervention approach targeting the common factors may effectively address the comorbidity.

Unveiling Transitions in Disease States: Study of Depressive and Anxiety Symptom Networks over Time

Background. Major depressive disorder (MDD) and anxiety disorders (AD) have high degrees of comorbidity and show great overlap in symptoms. The analysis of covarying depressive‐ and anxiety symptoms in longitudinal, sparse data panels has received limited attention. Dynamic time warping (DTW) analysis may help to provide new insights into symptom network properties based on diagnostic‐ and disease‐state stability criteria. Materials and Methods. In the Netherlands Study of Depression and Anxiety depressive‐, anxiety‐, and worry symptoms were assessed four or five times over the course of 9 years using self‐report questionnaires. The sample included 1,649 participants at baseline, comprising controls (n = 360), AD patients (n = 158), MDD patients (n = 265), and comorbid AD–MDD patients (n = 866). With DTW, 1,649 distance matrices were calculated, which yielded symptom networks and enabling comparison of network densities among subgroups. Results. The mean age of the sample was 41.5 years (standard deviations, 13.2), of whom 66.4% were female. The largest distance was between worry symptoms and physiological arousal symptoms, implicating the most dissimilar dynamics over time. The network density in the groups, from lowest to highest, followed the order: controls, AD, MDD, and comorbid AD–MDD. The comorbid group showed strongly connected mood and cognitive symptoms, which contrasted with the more strongly connected somatic and arousal symptoms in the AD and MDD groups. Groups that showed more transitions in disease states over follow‐up, regardless of the diagnoses, had the highest network density compared to more stable states of health or disease (beta for quadratic term = −0.095; P &lt; 0.001). Conclusions. Symptom networks over time can be visualized by applying DTW methods on sparse panel data. Network density was highest in patients with comorbid anxiety and depressive disorders and those with more instability in disease states, suggesting that a stronger internal connectivity may facilitate “critical transitions” within the complex systems framework.

LD block disorder-specific pleiotropic roles of novel CRHR1 in type 2 diabetes and depression disorder comorbidity

AbstractMajor depressive disorder (MDD) and type 2 diabetes (T2D) are complex disorders whose comorbidity can be due to hypercortisolism and may be explained by dysfunction of the corticotropin-releasing hormone receptor 1 (CRHR1) and cortisol feedback within the hypothalamic–pituitary–adrenal axis (HPA axis). To investigate the role of the CRHR1 gene in familial T2D, MDD, and MDD-T2D comorbidity, we tested 152 CRHR1 single-nucleotide-polymorphisms (SNPs), via 2-point parametric linkage and linkage disequilibrium (LD; i.e., association) analyses using 4 models, in 212 peninsular families with T2D and MDD. We detected linkage/LD/association to/with MDD and T2D with 122 (116 novel) SNPs. MDD and T2D had 4 and 3 disorder-specific novel risk LD blocks, respectively, whose risk variants reciprocally confirm one another. Comorbidity was conferred by 3 novel independent SNPs. In silico analyses reported novel functional changes, including the binding site of glucocorticoid receptor-alpha [GR-α] on CRHR1 for transcription regulation. This is the first report of CRHR1 pleiotropic linkage/LD/association with peninsular familial MDD and T2D. CRHR1 contribution to MDD is stronger than to T2D and may antecede T2D onset. Our findings suggest a new molecular-based clinical entity of MDD-T2D and should be replicated in other ethnic groups.

Outcomes Among Hospitalized Patients with Acute Chest Syndrome and Concomitant Clinical Depression: A United States Population-Based Cohort Study

Background Acute chest syndrome is a life-threatening complication of sickle cell disease, seen in both children and adults. Hospitalization and immediate treatment are necessary to prevent morbidity and mortality. Clinical depression is quite prevalent in patients with sickle cell disease, and review of literature reveals association of depression with increased annual emergency department visits, hospitalizations, and blood transfusions in patients with sickle cell disease. Whether this leads to worse outcomes is yet to be ascertained. Methods We utilized the 2018-2020 National Inpatient Sample (NIS) Database in conducting a retrospective cohort study. We identified hospitalized patients with acute chest syndrome and concomitant clinical depression using appropriate ICD-10 CM codes. We stratified patients based on whether they had clinical depression during the hospitalization or not. A survey multivariable logistic and linear regression analysis was used to calculate adjusted odds ratios (OR) for the primary and secondary outcomes. A p value of &amp;lt;0.05 was considered statistically significant. The aim of this study is to investigate the outcomes among hospitalized patients with acute chest syndrome and comorbid clinical depression looking primarily at the in-hospital mortality and hospital length of stay (LOS). Results We identified a total of 5271 hospitalized patients with acute chest syndrome, of which 10.72% (565/5271) had comorbid clinical depression. The overall in-hospital mortality among those with acute chest syndrome was 3.70% (195/5271). Among those with clinical depression, the overall in-hospital mortality rate was not significantly higher at 5.31% (30/565) (p=0.385). Utilizing a stepwise survey multivariable logistic regression model that adjusted for patient and hospital level confounders, clinical depression among hospitalized patients with acute chest syndrome did not significantly increase the risk for in-hospital mortality (adjusted OR 1.39, 95% confidence interval [CI], 0.49-3.91; p=0.533) or prolong hospital LOS (median LOS 6 days versus 7 days, p=0.631) Conclusion Acute chest syndrome continues to be an important cause of hospital admissions in patients with sickle cell disease. Our analysis revealed that clinical depression is commonly encountered in this subset of patients. Clinical depression did not have a statistically significant impact on outcomes including increased in-hospital mortality or prolonged hospital LOS. Prospective studies with large sample sizes are needed to better understand these outcomes.

Unified Protocol for the transdiagnostic treatment of emotional disorders in people with post COVID-19 condition: study protocol for a multiple baseline n-of-1 trial.

Post COVID-19 syndrome, defined as the persistence of COVID-19 symptoms beyond 3 months, is associated with a high emotional burden. Post COVID-19 patients frequently present comorbid anxiety, depressive and related disorders (emotional disorders, EDs) which have an important impact on their quality of life. Unfortunately, psychological interventions to manage these EDs are rarely provided to post COVID-19 patients. Also importantly, most psychological interventions do not address comorbidity, namely simultaneous EDs present in COVID-19 patients. This study will explore the clinical utility and acceptability of a protocol-based cognitive-behavioral therapy called the Unified Protocol for the transdiagnostic treatment of EDs in patients suffering post COVID-19 condition. A multiple baseline n-of-1 trial will be used, as it allows participants to be their own comparison control. Sample will be composed of 60 patients diagnosed with post COVID-19 conditions and comorbid EDs from three Spanish hospitals. After meeting the eligibility criteria, participants will answer the pre-assessment protocol and then they will be randomly assigned to three different baseline conditions (6, 8, or 10 days of assessments before the intervention). Participants and professionals will be unblinded to participants' allocation. Once the baseline assessment has been completed, participants will receive the online psychological individual intervention through video-calls. The Unified Protocol intervention will comprise 8 sessions of a 1 h duration each. After the intervention, participants will answer the post-assessment protocol. Additional follow-up assessments will be conducted at one, three, six, and twelve months after the intervention. Primary outcomes will be anxiety and depressive symptoms. Secondary outcomes include quality of life, emotion dysregulation, distress tolerance, and satisfaction with the programme. Data analyses will include between-group and within-group differences and visual analysis of patients' progress. Results from this study will be disseminated in scientific journals. These findings may help to provide valuable information in the implementation of psychological interventions for patients suffering post COVID-19 conditions. https://clinicaltrials.gov, identifier (NCT05581277).

Prevalence of suicidality in children and adolescents with depressive disorders with and without epilepsy

ObjectiveChildren with epilepsy (CWE) are at risk for a range of adverse emotional, behavioral, and social outcomes. Approximately one-third of CWE experience depressive disorders, and up to 20% of children and adolescents with epilepsy may experience suicidality, suggesting that epilepsy increases the risk for suicidality among children and adolescents with depressive disorders. Consequently, the goal of the present study is to compare rates of suicidality in children and adolescents diagnosed with depressive disorders with or without co-morbid epilepsy. Participants and methodsA retrospective chart review was conducted for 100 pediatric patients with a history of both seizures and depressive disorders and 100 patients with a history of depressive disorders only. Cases were coded for depression diagnosis, suicidality, suicidal ideation, suicide attempts, psychiatric hospitalizations, and self-injury. The distributions of these variables for the two groups were compared. ResultsThe age and sex distributions of the two groups were comparable. Patients with co-morbid depressive disorders and epilepsy found a high rate of suicidal ideation (69%) but did not differ from those with depressive disorders without epilepsy on any of the suicidality variables (all p > 0.20), with the exception of self-injury, which was higher in those without epilepsy. ConclusionsCWE and co-morbid depression are at significant risk for suicidality, including ideation, attempts, and hospitalizations, but at rates that are comparable to those with depressive disorders without seizures. However, patients with co-morbid epilepsy are less likely to engage in other self-injurious behaviors. These findings support the need for careful monitoring of the psychiatric status of children and adolescents with epilepsy.

The Role of the Adrenal-Gut-Brain Axis on Comorbid Depressive Disorder Development in Diabetes.

Diabetic patients are more affected by depression than non-diabetics, and this is related to greater treatment resistance and associated with poorer outcomes. This increase in the prevalence of depression in diabetics is also related to hyperglycemia and hypercortisolism. In diabetics, the hyperactivity of the HPA axis occurs in parallel to gut dysbiosis, weakness of the intestinal permeability barrier, and high bacterial-product translocation into the bloodstream. Diabetes also induces an increase in the permeability of the blood-brain barrier (BBB) and Toll-like receptor 4 (TLR4) expression in the hippocampus. Furthermore, lipopolysaccharide (LPS)-induced depression behaviors and neuroinflammation are exacerbated in diabetic mice. In this context, we propose here that hypercortisolism, in association with gut dysbiosis, leads to an exacerbation of hippocampal neuroinflammation, glutamatergic transmission, and neuronal apoptosis, leading to the development and aggravation of depression and to resistance to treatment of this mood disorder in diabetic patients.

Social avoidance and altered hypothalamic-pituitary-adrenal axis in a mouse model of anxious depression: The role of LPA1 receptor

Anxious depression is a prevalent disease with devastating consequences. Despite the lack of knowledge about the neurobiological basis of this subtype of depression, recently our group has identified a relationship between the LPA1 receptor, one of the six characterized G protein-coupled receptors (LPA1–6) for lysophosphatidic acid, with a mixed depressive-anxiety phenotype. Dysfunctional social behaviors, which have been related to increased activation of the hypothalamus-pituitary-adrenal (HPA) axis, are key symptoms of depression and are even more prominent in patients with comorbid anxiety and depressive disorders. Social behavior and HPA functioning were assessed in animals lacking the LPA1 receptor. For these purposes, we first examined social behaviors in wild-type and LPA1 receptor-null mice. In addition, a dexamethasone (DEX) suppression test was carried out. maLPA1-null mice exhibited social avoidance, a blunted response to DEX administration and an impaired circadian rhythm of corticosterone levels, which are features that are consistently dysregulated in many mental illnesses including anxious depression. Here, we have strengthened the previous experimental evidence for maLPA1-null mice to represent a good animal model of anxious depression, providing an opportunity to explore new therapeutic targets for the treatment of mood disorders, particularly this subtype of depression.

Examining nuanced targets in comorbid anxiety and depressive disorder treatment: Commentary on Öst et al. (2023).

Examining nuanced targets in comorbid anxiety and depressive disorder treatment: Commentary on Öst et al. (2023).

Exposure therapy for panic disorder and agoraphobia in the context of existing antidepressive medication

Cognitive behavioral therapy (CBT) and pharmacotherapy with antidepressants are both a highly effective treatment for agoraphobia and/or panic disorder; however, acombination of CBT and antidepressants is under debate due to potentially unfavorable interference effects. The associations of existing antidepressant medication with panic and agoraphobia symptom burden and their change in the context of astructured 5‑week day hospital and exposure-focused treatment in anaturalistic setting were investigated. Out of atotal of n = 488 patients medication use during treatment was retrospectively determined for n = 380: n = 100 (26.3%) were taking antidepressants of different drug classes. Calculations were performed using multiple linear regression analysis, t‑tests, response analyses, and χ2-tests. Patients with existing antidepressant medication more often met the criteria for comorbid depressive disorder (p < 0.001). The measure of symptom change and treatment response rates did not differ between patients with and without antidepressants with respect to anxiety symptoms. In the context studied, patients with and without existing antidepressant medication benefited equally from CBT with respect to anxiety symptoms.