Antioxidant uric acid is lower in current major depression and anxiety disorders

2016 ◽  
Vol 33 (S1) ◽  
pp. s220-s220 ◽  
Author(s):  
C. Black ◽  
M. Bot ◽  
P. Scheffer ◽  
B. Penninx

IntroductionIt has been hypothesized that lowered antioxidant capacity, which leads to increased oxidative stress, may be involved in the pathophysiology of major depressive disorder (MDD) and anxiety disorders and might be altered by antidepressant treatment.ObjectivesThis study investigated the association of plasma uric acid, the greatest contributor to blood antioxidant capacity, with MDD, generalized anxiety disorder, social phobia, panic disorder, agoraphobia and antidepressants in a large cohort.MethodsData was derived from the Netherlands Study of Depression and Anxiety including patients with current (n = 1648) or remitted (n = 609) MDD and/or anxiety disorder(s) (of which n = 710 antidepressant users) and 618 controls. Diagnoses were established with the Composite Interview Diagnostic Instrument. Symptom severity was ascertained in all participants with the Inventory of Depressive Symptoms and the Beck Anxiety Inventory. ANCOVA and regression analyses were adjusted for sociodemographic, health and lifestyle variables.ResultsPlasma uric acid was lower in those with current MDD and/or anxiety disorder(s) (adjusted mean 270 μmol/L) compared to those with remitted disorders (280 μmol/L, P < 0.001) or to controls (281 μmol/L, P < 0.001; Cohen's d 0.14). Within patients antidepressants were not associated with uric acid levels. Increasing symptom severity was associated with lower uric acid levels for both depression (β = –0.05, P = 0.001) and anxiety symptoms (β = –0.05, P = 0.004).ConclusionThis large scale study finds that the antioxidant uric acid is lower in current, but not remitted, MDD or anxiety disorders and in persons with higher symptom severity, suggesting disturbances in redox homeostasis play a role in the pathophysiology of depression and anxiety disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2016 ◽  
Vol 33 (S1) ◽  
pp. s219-s219
Author(s):  
C. Black ◽  
M. Bot ◽  
P. Scheffer ◽  
B. Penninx

IntroductionOxidative stress has been implicated in the pathophysiology of depression and anxiety disorders and may be influenced by antidepressant use.ObjectivesThis study investigated the association of oxidative stress, measured by plasma levels of F2-isoprostanes and 8-hydroxy-2′-deoxyguanosine (8-OHdG), reflecting oxidative lipid and DNA damage respectively, with major depressive disorder (MDD), generalized anxiety disorder, social phobia, panic disorder, agoraphobia and antidepressant use in a large cohort.MethodsData was derived from the Netherlands Study of Depression and Anxiety including patients with current (n = 1641) or remitted (n = 610) MDD and/or anxiety disorder(s) (of which n = 709 antidepressant users) and 633 controls. Diagnoses were established with the Composite Interview Diagnostic Instrument. Plasma 8-OHdG and F2-isoprostanes were measured using UHPLC-MS/MS. ANCOVA was performed adjusting for sampling, sociodemographic, health and lifestyle variables.ResultsF2-isoprostanes did not differ between controls and patients, or by antidepressant use. Patients (current or remitted) using antidepressants had lower 8-OHdG (adjusted mean 38.3 pmol/L) compared to patients (current or remitted) without antidepressants (44.7 pmol/L) and controls (44.9 pmol/L, P < 0.001; Cohen's d 0.26). Findings for 8-OHdG were similar over all disorders and all antidepressant types (SSRIs, TCAs, SNRIs; P < 0.001).ConclusionContrary to previous findings this large-scale study did not find increased oxidative stress measured by F2-isoprostanes or 8-OHdG in MDD or anxiety disorders. 8-OHdG levels were lower in antidepressant users, which suggests antidepressants may have antioxidant properties.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Author(s):  
Molly R Davies ◽  
Joshua E. J. Buckman ◽  
Brett N Adey ◽  
Cherie Armour ◽  
John R Bradley ◽  
...  

Background: Research to understand the complex aetiology of depressive and anxiety disorders often requires large sample sizes, but this comes at a cost. Large-scale studies are typically unable to utilise "gold standard" phenotyping methods, instead relying on remote, self-report measures to ascertain phenotypes. Aims: To assess the comparability of two commonly used phenotyping methods for depression and anxiety disorders. Method: Participants from the Genetic Links to Anxiety and Depression (GLAD) Study (N = 37,419) completed an online questionnaire including detailed symptom reports. They received a lifetime algorithm-based diagnosis based on DSM-5 criteria for major depressive disorder (MDD), generalised anxiety disorder (GAD), specific phobia, social anxiety disorder, panic disorder, and agoraphobia. Any anxiety disorder included participants with at least one anxiety disorder. Participants also responded to single-item questions asking whether they had ever been diagnosed with these disorders by health professionals. Results: Agreement for algorithm-based and single-item diagnoses was high for MDD and any anxiety disorder but low for the individual anxiety disorders. For GAD, many participants with a single-item diagnosis did not receive an algorithm-based diagnosis. In contrast, algorithm-based diagnoses of the other anxiety disorders were more common than the single-item diagnoses. Conclusions: The two phenotyping methods were comparable for MDD and any anxiety disorder cases. However, frequencies of specific anxiety disorders varied depending on the method. Single-item diagnoses classified most participants as having GAD whereas algorithm-based diagnoses were more evenly distributed across the anxiety disorders. Future investigations of specific anxiety disorders should use algorithm-based or other robust phenotyping methods.


Author(s):  
Holly J. Baker ◽  
Peter J. Lawrence ◽  
Jessica Karalus ◽  
Cathy Creswell ◽  
Polly Waite

AbstractAnxiety disorders are common in adolescence but outcomes for adolescents are unclear and we do not know what factors moderate treatment outcome for this age group. We conducted meta-analyses to establish the effectiveness of psychological therapies for adolescent anxiety disorders in (i) reducing anxiety disorder symptoms, and (ii) remission from the primary anxiety disorder, compared with controls, and examine potential moderators of treatment effects. The protocol was registered with PROSPERO (CRD42018091744). Electronic databases (Web of Science, MEDLINE, Psycinfo, EMBASE) were searched from January 1990 to December 2019. 2511 articles were reviewed, those meeting strict criteria were included. Random effects meta-analyses were conducted. Analyses of symptom severity outcomes comprised sixteen studies (CBT k = 15, non-CBT k = 1; n = 766 adolescents), and analyses of diagnostic remission outcomes comprised nine (CBT k = 9; n = 563 adolescents). Post-treatment, those receiving treatment were significantly more likely to experience reduced symptom severity (SMD = 0.454, 95% CI 0.22–0.69) and remission from the primary anxiety disorder than controls (RR = 7.94, 95% CI 3.19–12.7) (36% treatment vs. 9% controls in remission). None of the moderators analysed were statistically significant. Psychological therapies targeting anxiety disorders in adolescents are more effective than controls. However, with only just over a third in remission post-treatment, there is a clear need to develop more effective treatments for adolescents, evaluated through high-quality randomised controlled trials incorporating active controls and follow-up data.


2020 ◽  
pp. 1-10 ◽  
Author(s):  
R. A. Schoevers ◽  
C. D. van Borkulo ◽  
F. Lamers ◽  
M.N. Servaas ◽  
J. A. Bastiaansen ◽  
...  

Abstract Background There is increasing interest in day-to-day affect fluctuations of patients with depressive and anxiety disorders. Few studies have compared repeated assessments of positive affect (PA) and negative affect (NA) across diagnostic groups, and fluctuation patterns were not uniformly defined. The aim of this study is to compare affect fluctuations in patients with a current episode of depressive or anxiety disorder, in remitted patients and in controls, using affect instability as a core concept but also describing other measures of variability and adjusting for possible confounders. Methods Ecological momentary assessment (EMA) data were obtained from 365 participants of the Netherlands Study of Depression and Anxiety with current (n = 95), remitted (n = 178) or no (n = 92) DSM-IV defined depression/anxiety disorder. For 2 weeks, five times per day, participants filled-out items on PA and NA. Affect instability was calculated as the root mean square of successive differences (RMSSD). Tests on group differences in RMSSD, within-person variance, and autocorrelation were performed, controlling for mean affect levels. Results Current depression/anxiety patients had the highest affect instability in both PA and NA, followed by remitters and then controls. Instability differences between groups remained significant when controlling for mean affect levels, but differences between current and remitted were no longer significant. Conclusions Patients with a current disorder have higher instability of NA and PA than remitted patients and controls. Especially with regard to NA, this could be interpreted as patients with a current disorder being more sensitive to internal and external stressors and having suboptimal affect regulation.


2011 ◽  
Vol 26 (S2) ◽  
pp. 138-138
Author(s):  
A. Bener

AimTo determine the prevalence of anxiety and depressive disorders in Qatari population who attend the primary health care settings and examine their symptoms patterns and co-morbidity.DesignA cross sectional.SettingPrimary health care center, QatarSubjectsA total of 2080 Qatari subjects aged 18 to 65 years were approached and 1660 (79.8%) patients participated in this study.MethodsThe study was based on a face to face interview with a designed diagnostic screening questionnaire which consists of 17 questions about symptoms and signs of anxiety and depression disorders. Physicians determined the definitive diagnosis for depression and anxiety disorders by further checking and screening their symptoms.ResultsThe overall prevalence of depression and anxiety disorder was 13.5% and 10.3% respectively. Qatari women were at higher risk for depression (53.1% vs 46.9%) and anxiety disorder (56.7% vs 43.3%) compared to men. More than half of the sufferers with anxiety (56.7%) and depression (53.1%) were Qatari women with a higher frequency in the age group 1834 years. There were significant differences between men and women with depression in terms of age group (p = 0.004), marital status (p = 0.04), occupation (p < 0.001) and household income (p = 0.002). Nervousness was the most common symptom in subjects with anxiety disorders (68.4%), whereas sleep difficulty was the most common symptom in subjects with depressive disorder (59.4%).ConclusionThe depression was more prevalent in Qatari than anxiety disorders. The high risk groups of depression and anxiety disorders were being female, married, middle aged and highly educated.


2020 ◽  
pp. 1-11
Author(s):  
Pasquale Roberge ◽  
Martin D. Provencher ◽  
Isabelle Gaboury ◽  
Patrick Gosselin ◽  
Helen-Maria Vasiliadis ◽  
...  

Abstract Background Transdiagnostic group cognitive-behavioral therapy (tCBT) is a delivery model that could help overcome barriers to large-scale implementation of evidence-based psychotherapy for anxiety disorders. The aim of this study was to assess the effectiveness of combining group tCBT with treatment-as-usual (TAU), compared to TAU, for the treatment of anxiety disorders in community-based mental health care. Methods In a multicenter single-blind, two-arm pragmatic superiority randomized trial, we recruited participants aged 18–65 who met DSM-5 criteria for principal diagnoses of generalized anxiety disorder, social anxiety disorder, panic disorder, or agoraphobia. Group tCBT consisted of 12 weekly 2 h sessions. There were no restrictions for TAU. The primary outcome measures were the Beck Anxiety Inventory (BAI) and clinician severity rating from the Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5) for the principal anxiety disorder at post-treatment, with intention-to-treat analysis. Results A total of 231 participants were randomized to either tCBT + TAU (117) or TAU (114), with outcome data available for, respectively, 95 and 106. Results of the mixed-effects regression models showed superior improvement at post-treatment for participants in tCBT + TAU, compared to TAU, for BAI [p < 0.001; unadjusted post-treatment mean (s.d.): 13.20 (9.13) v. 20.85 (10.96), Cohen's d = 0.76] and ADIS-5 [p < 0.001; 3.27 (2.19) v. 4.93 (2.00), Cohen's d = 0.79]. Conclusions Our findings suggest that the addition of group tCBT into usual care can reduce symptom severity in patients with anxiety disorders, and support tCBT dissemination in routine community-based care.


Diabetes ◽  
2013 ◽  
Vol 63 (3) ◽  
pp. 976-981 ◽  
Author(s):  
E. Fabbrini ◽  
M. Serafini ◽  
I. Colic Baric ◽  
S. L. Hazen ◽  
S. Klein

2009 ◽  
Vol 40 (7) ◽  
pp. 1101-1111 ◽  
Author(s):  
K. A. Glashouwer ◽  
P. J. de Jong

BackgroundCognitive theory points to the importance of negative self-schemas in the onset and maintenance of depression and anxiety disorders. Hereby, it is important to distinguish between automatic and explicit self-schemas, reflecting different cognitive-motivational systems. This study tested whether patients with a current major depression and/or anxiety disorder are characterized by automatic self-anxious and self-depressive associations and whether these associations are disorder specific.MethodPatients (n=2329) and non-clinical controls (n=652) were tested as part of The Netherlands Study of Depression and Anxiety, a multi-center, longitudinal, cohort study with patients from different health care settings. Patient groups and non-clinical controls (18–65 years of age) were compared with regard to automatic self-anxious and self-depressive associations measured with the Implicit Association Test.ResultsIndividuals with an anxiety disorder showed enhanced self-anxious associations, whereas individuals with a depression showed enhanced self-depressive associations. Individuals with co-morbid disorders scored high on both automatic self-associations. Although remitted individuals showed weaker automatic self-associations than people with a current disorder, their automatic self-anxious/depressed associations were still significantly stronger than those of the control group. Importantly, automatic self-associations showed predictive validity for the severity of anxious and depressive symptoms over and above explicit self-beliefs.ConclusionsThis study represents the first evidence that automatic self-anxious and self-depressive associations are differentially involved in anxiety disorders and depression. This may help to explain the refractoriness of these disorders and points to the potential importance of automatic self-associations in the development of psychopathological symptoms.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Philip Spinhoven ◽  
Bernet M. Elzinga ◽  
Brenda W. J. H. Penninx ◽  
Erik J. Giltay

Abstract Background Notwithstanding the firmly established cross-sectional association of happiness with psychiatric disorders and their symptom severity, little is known about their temporal relationships. The goal of the present study was to investigate whether happiness is predictive of subsequent psychiatric disorders and symptom severity (and vice versa). Moreover, it was examined whether changes in happiness co-occur with changes in psychiatric disorder status and symptom severity. Methods In the Netherlands Study of Depression and Anxiety (NESDA), happiness (SRH: Self-Rated Happiness scale), depressive and social anxiety disorder (CIDI: Composite Interview Diagnostic Instrument) and depressive and anxiety symptom severity (IDS: Inventory of Depressive Symptomatology; BAI: Beck Anxiety Inventory; and FQ: Fear Questionnaire) were measured in 1816 adults over a three-year period. Moreover, we focused on occurrence and remittance of 6-month recency Major Depressive Disorder (MDD) and Social Anxiety Disorders (SAD) as the two disorders most intertwined with subjective happiness. Results Interindividual differences in happiness were quite stable (ICC of .64). Higher levels of happiness predicted recovery from depression (OR = 1.41; 95% CI = 1.10–1.80), but not social anxiety disorder (OR = 1.31; 95%CI = .94–1.81), as well as non-occurrence of depression (OR = 2.41; 95%CI = 1.98–2.94) and SAD (OR = 2.93; 95%CI = 2.29–3.77) in participants without MDD, respectively SAD at baseline. Higher levels of happiness also predicted a reduction of IDS depression (sr = − 0.08; 95%CI = -0.10 - -0.04), and BAI (sr = − 0.09; 95%CI = -0.12 - -0.05) and FQ (sr = − 0.06; 95%CI = -0.09 - -0.04) anxiety symptom scores. Conversely, presence of affective disorders, as well as higher depression and anxiety symptom severity at baseline predicted a subsequent reduction of self-reported happiness (with marginal to small sr values varying between −.04 (presence of SAD) to −.17 (depression severity on the IDS)). Moreover, changes in happiness were associated with changes in psychiatric disorders and their symptom severity, in particular with depression severity on the IDS (sr = − 0.46; 95%CI = −.50 - -.42). Conclusions Results support the view of rather stable interindividual differences in subjective happiness, although level of happiness is inversely associated with changes in psychiatric disorders and their symptom severity, in particular depressive disorder and depression severity.


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