Effect of Dupilumab on Depression in Asthma with Eosinophilic Chronic Rhinosinusitis in the Japanese Population

2021 ◽  
pp. 1-9
Author(s):  
Toshiyuki Koya ◽  
Natsumi Sakai ◽  
Takanobu Sasaki ◽  
Kaori Shinbori ◽  
Asuka Nagai ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Chronic Rhinosinusitis ◽  
Symptom Score ◽  
Clinical Symptoms ◽  
Nasal Symptom ◽  
Depressive State ◽  
Airway Diseases ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Patient Health ◽  
Study Participants

<b><i>Introduction:</i></b> Psychological disorders, such as depression, are markedly prevalent in patients with airway diseases. In this study, we assessed the effect of treatment with dupilumab, an IL-4 receptor α chain antibody, on depressive symptoms in a cohort of patients with asthma with eosinophilic chronic rhinosinusitis (ECRS). <b><i>Methods:</i></b> The study participants, diagnosed with asthma and ECRS, were assessed for symptoms and quality of life (QOL) scores for asthma and ECRS and medications. The Patient Health Questionnaire-9 (PHQ-9) scores were used to evaluate the depressive state. The depressive symptoms were compared with asthma and ECRS symptoms both at the time of initiation and after 4 months of dupilumab treatment. <b><i>Results:</i></b> Ultimately, 31 patients were included in the study. Most patients demonstrated a depressive state that was correlated with the nasal symptom score. In the evaluation 4 months after dupilumab treatment, the PHQ-9 score was significantly reduced, and the decrease was remarkable in patients whose nasal symptom score was reduced by 50% or more. Additionally, the PHQ-9 scores in patients with improved nasal and asthma symptoms were significantly reduced. <b><i>Discussion/Conclusion:</i></b> Dupilumab may improve QOL in patients with bronchial asthma with ECRS by reducing depressive symptoms through the improvement of clinical symptoms.

scholarly journals Associations of Symptomatic- and Anatomical-Based Severity of Chronic Rhinosinusitis With Patients' Anxiety and Depression

2021 ◽  
Author(s):  
Chenyang Lei ◽  
Zeyu Sun ◽  
Jiashu Yao ◽  
Xiandan Luo ◽  
Gaoyun Xiong
Keyword(s):  
Chronic Rhinosinusitis ◽  
Frontal Sinus ◽  
Univariate Analysis ◽  
Nasal Symptom ◽  
Ethmoid Sinus ◽  
Anxiety And Depression ◽  
Symptom Scores ◽  
Patient Health ◽  
High Incidence Rate ◽  
Ear Symptoms

Abstract Background Patients with chronic rhinosinusitis (CRS) have a high incidence rate of anxiety and depression. However, changes in anxiety and depression with different severities of CRS,and the effects of symptoms and anatomical factors on the anxiety and depression of CRS patients remain unclear.Methods A total of 112 patients were enrolled in the study. The Sino-Nasal Outcome Test-20 (SNOT-22) score, Lund-Mackay scale and Lund-Kennedy scale were used to assess the severity of CRS, and the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate anxiety and depression in patients. Results In the univariate analysis, SNOT-20 scores, nasal symptom scores, facial/ear symptom scores and sleep scores are significantly positively correlated with patients’ GAD-7 scores (all P<0.05); the patients’ SNOT-20 scores, nasal symptom scores, facial/ear symptom scores, sleep scores, and the higher side of the anterior ethmoid sinus and frontal sinus Lund-Mackay scores were significantly positively correlated with the patients’ PHQ-9 scores (all P<0.05). In a multivariate linear regression model, however, none of the covariates were found to be statistically associated with GAD-7. Another multivariate model indicated associations among the SNOT-20 sleep domain scores, the higher side of frontal sinus Lund- Mackay scores and PHQ-9 scores (both P < 0.01). Conclusions Exacerbated nasal and facial/ear symptoms, sleep dysfunction increase patients’ depression and anxiety. Lesions of the frontal sinus and anterior ethmoid sinus may be related to patients' depression. Treatment should be tailored to patients with these symptoms.

scholarly journals Modified Lund Mackay Postoperative Endoscopy Score for defining inflammatory burden in chronic rhinosinusitis

2014 ◽  
Vol 52 (1) ◽  
pp. 53-59
Author(s):  
K. Snidvongs ◽  
D. Dalgorf ◽  
L. Kalish ◽  
R. Sacks ◽  
E. Pratt ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Chronic Rhinosinusitis ◽  
Symptom Score ◽  
Analogue Scale ◽  
Nasal Symptom ◽  
Sinus Surgery ◽  
Observer Reliability ◽  
Patient Reported ◽  
Snot 22 ◽  
Inflammatory Burden

Objective: The Lund Mackay Postoperative Endoscopy Score (LMES) for chronic rhinosinusitis (CRS) is a poor measure of the patient experience. A proposed Modified Lund Mackay Postoperative Endoscopy Score (MLMES) aims to better describe the inflammatory burden in CRS. Methods: A prospective study on CRS patients having endoscopic sinus surgery (ESS) was conducted. Endoscopy was recorded at the 6th and the 12th week post-op. The MLMES recorded changes in mucosa, mucus and purulence for each of the maxillary, ethmoid, sphenoid, frontal sinuses and olfactory fossa in post-ESS cavities. The correlation between MLMES and visual analogue scale of total rhinosinusitis symptoms, global anchor score of nasal function, Sino-Nasal Outcome Test 22 (SNOT-22) and nasal symptom score was analyzed. The inter-observer reliability, intra-observer reliability and correlation between the change in MLMES and in subjective measures were also investigated. Results: Thirty patients were assessed. The MLMES significantly correlated with visual analogue scale, SNOT-22, global anchor and nasal symptom score. The change in MLMES correlated with the change in SNOT-22 and nasal symptom score. The inter-observer and intra-observer reliability were excellent. Conclusion: Objectives measurements for post-ESS patients can be reconsidered to represent the cumulative inflammatory burden of all sinuses. The proposed MLMES represents total sinus inflammatory burden and correlates well with patient reported outcome measures.

scholarly journals Toll-like receptor 4-mediated cytokine synthesis and post-stroke depressive symptoms

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michal Korostynski ◽  
Dzesika Hoinkis ◽  
Marcin Piechota ◽  
Slawomir Golda ◽  
Joanna Pera ◽  
...  
Keyword(s):  
Gene Expression ◽  
Depressive Symptoms ◽  
Ex Vivo ◽  
Toll Like Receptor ◽  
Toll Like Receptor 4 ◽  
Post Stroke ◽  
Cytokines And Chemokines ◽  
Patient Health ◽  
Post Stroke Depression ◽  
Cytokine Synthesis

AbstractAltered cytokine synthesis thought to contribute to the pathophysiology of post-stroke depression (PSD). Toll-like receptor 4 (TLR4) is a master regulator of innate immunity. The aim of this study was to explore the putative association between TLR4-mediated cytokine synthesis and subsequent symptoms of PSD. In total, 262 patients with ischemic stroke and without a history of PSD were included. Depressive symptoms were assessed using the Patient Health Questionnaire-9 in 170 patients on Day 8 and in 146 at 3 months after stroke. Blood samples taken on Day 3 after stroke were stimulated ex vivo with lipopolysaccharide (LPS). Ex vivo synthesized cytokines (TNFα, IP-10, IL-1β, IL-6, IL-8, IL-10, and IL-12p70) and circulating cytokines (TNFα, IL-6, sIL-6R, and IL-1ra) were measured using the enzyme-linked immunoassay or cytometric method. RNA sequencing was used to determine the gene expression profile of LPS-induced cytokines and chemokines. LPS-induced cytokine synthesis and the gene expression of TLR4-dependent cytokines and chemokines did not differ between patients with and without greater depressive symptoms. The plasma level of IL-6, but not TNFα, sIL-6R, and IL-1ra, was higher in patients who developed depressive symptoms at 3 months after stroke (median: 4.7 vs 3.4 pg/mL, P = 0.06). Plasma IL-6 predicted the severity of depressive symptoms at 3 months after stroke (β = 0.42, P = 0.03). In conclusion, TLR4-dependent cytokine synthesis was not associated with greater post-stroke depressive symptoms in this study. Circulating IL-6 might be associated with depressive symptoms occurring at 3 months after stroke.

scholarly journals Associations of Dietary Patterns with Incident Depression: The Maastricht Study

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1034
Author(s):  
Vincenza Gianfredi ◽  
Annemarie Koster ◽  
Anna Odone ◽  
Andrea Amerio ◽  
Carlo Signorelli ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Dietary Patterns ◽  
Proportional Hazards ◽  
A Priori ◽  
Preventive Measure ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Healthy Diet ◽  
Patient Health

Our aim was to assess the association between a priori defined dietary patterns and incident depressive symptoms. We used data from The Maastricht Study, a population-based cohort study (n = 2646, mean (SD) age 59.9 (8.0) years, 49.5% women; 15,188 person-years of follow-up). Level of adherence to the Dutch Healthy Diet (DHD), Mediterranean Diet, and Dietary Approaches To Stop Hypertension (DASH) were derived from a validated Food Frequency Questionnaire. Depressive symptoms were assessed at baseline and annually over seven-year-follow-up (using the 9-item Patient Health Questionnaire). We used Cox proportional hazards regression analyses to assess the association between dietary patterns and depressive symptoms. One standard deviation (SD) higher adherence in the DHD and DASH was associated with a lower hazard ratio (HR) of depressive symptoms with HRs (95%CI) of 0.78 (0.69–0.89) and 0.87 (0.77–0.98), respectively, after adjustment for sociodemographic and cardiovascular risk factors. After further adjustment for lifestyle factors, the HR per one SD higher DHD was 0.83 (0.73–0.96), whereas adherence to Mediterranean and DASH diets was not associated with incident depressive symptoms. Higher adherence to the DHD lowered risk of incident depressive symptoms. Adherence to healthy diet could be an effective non-pharmacological preventive measure to reduce the incidence of depression.

Family Interaction and Depressive Symptoms in Chinese Emerging Adults: A Mediation Model of Gratitude

2021 ◽  
pp. 003329412110006
Author(s):  
Kelly Ka Lai Lam ◽  
Wei-Wen Chen
Keyword(s):  
Depressive Symptoms ◽  
Emerging Adults ◽  
Structural Equation ◽  
Family Interaction ◽  
Assessment Instrument ◽  
Equation Modeling ◽  
Mediation Model ◽  
Online Questionnaire ◽  
Patient Health ◽  
Healthy Family

In this study, we investigated the relations between family interaction, gratitude, and depressive symptoms among Chinese emerging adults. It also investigated gratitude as a mediator in the relation between family interaction and depression. Data were obtained from 321 college students who completed the online questionnaire about the Family Assessment Instrument, Gratitude Questionnaire, Patient Health Questionnaire, and demographic information. Structural equation modeling (SEM) was used to test hypotheses and bootstrapping with 5,000 resamplings (95% confidence interval) was used to confirm the mediation model. Results showed that gratitude partially mediated the relation between family interaction and depression. In other words, students with healthy family interaction, as indicated by perceived better family communication, mutuality, and harmony with family members, tended to report higher general gratitude, and subsequently diminished depressive symptoms. The practical implications were discussed.

Attitudes that determine willingness to seek psychiatric help for depression: a representative population survey applying the Theory of Planned Behaviour

2009 ◽  
Vol 39 (11) ◽  
pp. 1855-1865 ◽  
Author(s):  
G. Schomerus ◽  
H. Matschinger ◽  
M. C. Angermeyer
Keyword(s):  
Depressive Symptoms ◽  
Help Seeking ◽  
Theory Of Planned Behaviour ◽  
Population Sample ◽  
Path Model ◽  
Control Beliefs ◽  
Planned Behaviour ◽  
Telephone Interviews ◽  
Patient Health ◽  
Analogous Model

BackgroundMany people suffering from mental disorders do not seek appropriate help. We have examined attitudes that further or hinder help-seeking for depression with an established socio-psychological model, the Theory of Planned Behaviour (TPB), comparing models for respondents with and without depressive symptoms.MethodA qualitative preparatory study (n=29) elicited salient behavioural (BB), normative (NB) and control beliefs (CB) that were later included in the TPB questionnaire. Telephone interviews with a representative population sample in Germany (n=2303) started with a labelled vignette describing symptoms of a major depression, followed by items covering the components of the TPB. Intention to see a psychiatrist for the problem described was elicited at the beginning and at the end of the interview. We screened participants for current depressive symptoms using the mood subscale of the Patient Health Questionnaire (PHQ-9).ResultsIn non-depressed respondents (n=2167), a TPB path model predicted 42% of the variance for the first and 51% for the second question on intention. In an analogous model for depressed respondents (n=136), these values increased to 50% and 61% respectively. Path coefficients in both models were similar. In both depressed and non-depressed persons, attitude towards the behaviour was more important than the subjective norm, whereas perceived behavioural control was of minor influence.ConclusionsWillingness to seek psychiatric help for depression can largely be explained by a set of attitudes and beliefs as conceptualized by the TPB. Our findings suggest that changing attitudes in the general population are likely to effect help-seeking when people experience depressive symptoms.

scholarly journals Validation and calibration of the patient health questionnaire (PHQ-9) in Argentina

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
María Urtasun ◽  
Federico Manuel Daray ◽  
Germán Leandro Teti ◽  
Fernando Coppolillo ◽  
Gabriela Herlax ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Convergent Validity ◽  
Patient Health Questionnaire ◽  
Receiver Operating Curve ◽  
Local Version ◽  
Health Questionnaire ◽  
Good Ability ◽  
Patient Health ◽  
Severity Of Depression ◽  
Degrees Of Severity

Abstract Background The Patient Health Questionnaire-9 (PHQ-9) is a brief tool to assess the presence and severity of depressive symptoms. This study aimed to validate and calibrate the PHQ-9 to determine appropriate cut-off points for different degrees of severity of depression in Argentina. Methods We conducted a cross-sectional study on an intentional sample of adult ambulatory care patients with different degrees of severity of depression. All patients who completed the PHQ-9 were further interviewed by a trained clinician with the Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory-II (BDI-II). Reliability and validity tests, including receiver operating curve analysis, were performed. Results One hundred sixty-nine patients were recruited with a mean age of 47.4 years (SD = 14.8), of whom 102 were females (60.4%). The local PHQ-9 had high internal consistency (Cronbach’s alpha = 0.87) and satisfactory convergent validity with the BDI-II scale [Pearson’s correlation = 0.88 (p < 0.01)]. For the diagnosis of Major Depressive Episode (MDE) according to the MINI, a PHQ-9 ≥ 8 was the optimal cut-off point found (sensitivity 88.2%, specificity 86.6%, PPV 90.91%). The local version of PHQ-9 showed good ability to discriminate among depression severity categories according to the BDI-II scale. The best cut off points were 6–8 for mild cases, 9–14 for moderate and 15 or more for severe depressive symptoms respectively. Conclusions The Argentine version of the PHQ-9 questionnaire has shown acceptable validity and reliability for both screening and severity assessment of depressive symptoms.

scholarly journals Sex-Specific Associations of Trimethylamine-N-Oxide and Zonulin with Signs of Depression in Carbohydrate Malabsorbers and Nonmalabsorbers

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Sophie Meinitzer ◽  
Andreas Baranyi ◽  
Sandra Holasek ◽  
Wolfgang J. Schnedl ◽  
Sieglinde Zelzer ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Beck Depression Inventory ◽  
Intestinal Permeability ◽  
Serum Concentrations ◽  
Carbohydrate Malabsorption ◽  
Specific Relationship ◽  
Breath Testing ◽  
Lactase Gene ◽  
Study Participants ◽  
Gender Specific

Background. The microbiome-derived trimethylamine-N-oxide (TMAO) and the intestinal permeability marker zonulin are considered to be linked with depression. Moreover, carbohydrate malabsorption (CMA) was shown to be associated with signs of depression. This study is aimed at investigating possible sex-specific associations between TMAO and zonulin and the presence of depressive signs in individuals with and without CMA. Methods. Serum concentrations of TMAO and zonulin were determined in 115 and 136 individuals with the presence or absence of CMA. All 251 study participants underwent lactase gene C/T-13910 polymorphism genotyping and fructose H2/CH4 breath testing. Additionally, they filled in the Beck Depression Inventory (BDI-II) questionnaire. Results. The median TMAO and zonulin serum concentrations were 2.66 (1.93–4.14) μmol/L and 40.83 (34.73–47.48) ng/mL. Serum TMAO levels were positively correlated with depressive symptoms (P=0.011, ρ=0.160). The strongest correlations were observed in 87 females (P=0.010, ρ=0.274) and 49 males (P=0.027, ρ=0.315) without CMA, whereas 115 patients with CMA showed no significant correlations. Zonulin tended to be negatively correlated with the BDI-II score in 49 males without CMA (P=0.062, ρ=−0.269). Conclusion. This study demonstrates a positive correlationship between the serum TMAO concentrations and the severity of depressive symptoms in females and males without CMA. Serum zonulin levels were negatively correlated with signs of depression in males without CMA. These findings suggest a gender-specific relationship between the serum TMAO and zonulin concentrations, depression, and CMA.

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