scholarly journals Polymorphisms in BDNF (Val66Met) and 5-HTTLPR, morning cortisol and subsequent depression in at-risk adolescents

2010 ◽  
Vol 197 (5) ◽  
pp. 365-371 ◽  
Author(s):  
Ian M. Goodyer ◽  
Tim Croudace ◽  
Frank Dudbridge ◽  
Maria Ban ◽  
Joe Herbert
Keyword(s):  
Salivary Cortisol ◽  
Depressive Episode ◽  
Gene Promoter ◽  
Unipolar Depression ◽  
Increased Risk ◽  
Morning Cortisol ◽  
Multivariate Modelling ◽  
Show Evidence ◽  
Hypothalamic Pituitary Axis

BackgroundThere is increasing evidence for genetic effects on the hypothalamic–pituitary axis system. More than one gene is likely to moderate corticoid-mediated activity.AimsTo investigate whether the brain-derived neurotrophic factor (BDNF) polymorphism (rs6265, Val66Met) is associated with morning waking salivary cortisol and moderates the corticoid-mediated risk for subsequent depressive episode onset independently of the known effects of 5-HTTLPR (the serotonin transporter gene promoter).MethodHigh-risk adolescents (n = 401) were genotyped for Val66Met BDNF and 5-HTTLPR. Salivary samples were obtained on four consecutive school days within 1 h of waking. There were 365 (91%) remaining participants reassessed at 12 months for episodes of psychiatric disorder in the follow-up period. Of these, 357 (89%) had complete data for multivariate modelling.ResultsThere were 41 (11.2%) individuals who reported a new episode of clinical depression over the follow-up period. Increased risk for subsequent depression was found in carriers of the Val66Val genotype in BDNF with higher morning waking cortisol. This remained present when the known interaction between carriers of a short allele of 5-HTTLPR with higher morning salivary cortisol was taken into account.ConclusionsBoth BDNF and 5-HTTLPR genes show evidence of modifying the risk of a subsequent new depressive episode associated with elevated morning salivary cortisol. In adolescents morning salivary cortisol levels may constitute a biomarker for some forms of unipolar depression.

scholarly journals Serotonin transporter genotype, morning cortisol and subsequent depression in adolescents

2009 ◽  
Vol 195 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Ian M. Goodyer ◽  
Alison Bacon ◽  
Maria Ban ◽  
Tim Croudace ◽  
Joe Herbert
Keyword(s):  
High Risk ◽  
Serotonin Transporter ◽  
Depressive Episode ◽  
Gene Promoter ◽  
Depressive Illness ◽  
Short Allele ◽  
Morning Cortisol ◽  
Serotonin Transporter Genotype ◽  
S Allele ◽  
Subsequent Onset

BackgroundThe short (s) allele of the serotonin transporter gene promoter (5-HTTLPR) may be associated with exposure to social adversities and the subsequent onset of depressive illness in adulthood.AimsTo test in adolescents at high risk for depression whether the short ‘s’ allele is associated with levels of morning cortisol and the subsequent onset of a depressive episode.MethodHigh-risk adolescents (n = 403) were genotyped for 5-HTTLPR. Salivary samples were obtained on four consecutive school days within 1 h of waking from 393 (97.5%) individuals and 367 (91%) underwent a mental state reassessment at 12 months.ResultsMultilevel analysis revealed higher levels of salivary cortisol in short allele carriers (s/s>s/l>l/l). A subsequent episode of depression was increased in those with higher cortisol and the ‘s’ allele, and independently by depressive symptoms at entry, in both genders.ConclusionsThe short allele of 5-HTTLPR may moderate the association between morning cortisol and the subsequent onset of a depressive episode.

Ovoid palatal patch: a clue to anti-TIF1γ dermatomyositis

2020 ◽  
Vol 13 (4) ◽  
pp. e234111
Author(s):  
Ellen Franciosi ◽  
Kaitlin Blankenship ◽  
Laura Houk ◽  
Mehdi Rashighi
Keyword(s):  
Lupus Erythematosus ◽  
Cutaneous Lupus Erythematosus ◽  
Oral Exam ◽  
Increased Risk ◽  
Show Evidence ◽  
Risk Of Malignancy ◽  
History Of ◽  
Scalp Biopsy ◽  
Prompt Diagnosis

An 80-year-old woman presented with a several-year history of progressive hair loss and scalp pruritus. No other rashes or muscle weakness were noted on examination. Scalp biopsy showed interface dermatitis, dense perivascular and periadnexal lymphocytic infiltrate, mucin and scarring alopecia. Laboratory analysis did not show evidence of myositis. The patient was started on hydroxychloroquine for possible cutaneous lupus erythematosus. On follow-up, she presented with a new violaceous rash on the superior eyelids and a well-defined oval patch on the mid-hard palate suspicious for dermatomyositis. Myositis-specific autoantibodies revealed presence of anti-transcriptional intermediary factor-1γ (anti-TIF1γ) in the serum. Anti-TIF1γ autoantibody-positive dermatomyositis is a newly recognised subtype of dermatomyositis that is highly associated with amyopathic disease and has an increased risk of malignancy, making prompt diagnosis crucial. This case highlights the utility of a thorough oral exam in patients suspected to have connective tissue disease as the distinctive ovoid palatal patch is nearly pathognomonic for anti-TIF1γ dermatomyositis.

scholarly journals Adolescent cannabis use, depression and anxiety disorders in the Northern Finland Birth Cohort 1986

BJPsych Open ◽  
2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Antti Mustonen ◽  
Emily Hielscher ◽  
Jouko Miettunen ◽  
Alexander Denissoff ◽  
Anni-Emilia Alakokkare ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Birth Cohort ◽  
Unipolar Depression ◽  
Hazard Ratio ◽  
Cannabis Use ◽  
Depression And Anxiety ◽  
Causal Association ◽  
Increased Risk ◽  
Public Health Messages

Background Cannabis use has been associated with increased risk of psychiatric disorders. However, associations between adolescent cannabis use, depression and anxiety disorders are inconsistently reported in longitudinal samples. Aims To study associations of adolescent cannabis use with depression and anxiety disorders. Method We used data from the Northern Finland Birth Cohort 1986, linked to nationwide registers, to study the association between adolescent cannabis use and depression and anxiety disorders until 33 years of age (until 2018). Results We included 6325 participants (48.8% male) in the analyses; 352 (5.6%) participants reported cannabis use until 15–16 years of age. By the end of the follow-up, 583 (9.2%) participants were diagnosed with unipolar depression and 688 (10.9%) were diagnosed with anxiety disorder. Cannabis use in adolescence was associated with an increased risk of depression and anxiety disorders in crude models. After adjusting for parental psychiatric disorder, baseline emotional and behavioural problems, demographic factors and other substance use, using cannabis five or more times was associated with increased risk of anxiety disorders (hazard ratio 2.01, 95% CI 1.15–3.82), and using cannabis once (hazard ratio 1.93, 95% CI 1.30–2.87) or two to four times (hazard ratio 2.02, 95% CI 1.24–3.31) was associated with increased risk of depression. Conclusions Cannabis use in adolescence was associated with an increased risk of future depression and anxiety disorders. Further research is needed to clarify if this is a causal association, which could then inform public health messages about the use of cannabis in adolescence.

scholarly journals Morning cortisol as a risk factor for subsequent major depressive disorder in adult women

2000 ◽  
Vol 177 (6) ◽  
pp. 505-510 ◽  
Author(s):  
T. O. Harris ◽  
S. Borsanyi ◽  
S. Messari ◽  
K. Stanford ◽  
S. E. Cleary ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Risk Factor ◽  
Individual Differences ◽  
Depressive Disorder ◽  
Life Events ◽  
Salivary Cortisol ◽  
Adult Women ◽  
Major Depressive ◽  
Morning Cortisol

BackgroundWhether individual differences in cortisol contribute to subsequent major depressive disorder (MDD) is unknown.AimsTo determine whether premorbid levels of salivary cortisol and dehydroepiandrosterone (DHEA) were associated with subsequent MDD and how these related to psychosocial factors known to increase the risk for MDD.MethodAdult women (n=116) were recruited from general practices. None was currently depressed; 83 were ‘psychosocially vulnerable’ to MDD, 33 were not. Salivary steroids (cortisol and DHEA at 08.00 h and 20.00 h), recent life events, current mood and social support were assessed at entry. Onset of MDD was recorded during 13 months' follow-up.ResultsThere were no associations between salivary cortisol or DHEA and recent life events or vulnerability. Twenty-eight onsets of MDD occurred during the follow-up period. This was associated with: severe adverse life events and difficulties during the follow-up period; mean morning cortisol levels at entry; and the presence of any of three vulnerability factors.ConclusionsIndividual differences in morning salivary cortisol levels may represent an independent risk factor for subsequent MDD. The origin of these differences in cortisol is not yet understood.

scholarly journals IGF-I gene promoter polymorphism is a predictor of survival after myocardial infarction in patients with type 2 diabetes

2006 ◽  
Vol 155 (5) ◽  
pp. 751-756 ◽  
Author(s):  
Mojgan Yazdanpanah ◽  
Fakhredin A Sayed-Tabatabaei ◽  
Joop A M J L Janssen ◽  
Ingrid Rietveld ◽  
Albert Hofman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Gene Promoter ◽  
Population Based ◽  
Promoter Polymorphism ◽  
Increased Risk ◽  
Igf I ◽  
Genetically Determined

Objective: Previously we observed that non-carriers of the most common alleles of an IGF-I promoter polymorphism have low circulating IGF-I levels and an increased risk of developing myocardial infarction (MI), particularly in patients with type 2 diabetes. Design: We investigated whether this IGF-I promoter polymorphism is associated with survival of type 2 diabetes in a Caucasian population aged 55 years and older. Methods: The study was embedded in the Rotterdam Study, a prospective population-based cohort study. At baseline, 668 patients with type 2 diabetes were diagnosed, among which, 55 incident MI were ascertained during follow-up. For the present study, we used two genotype groups: non-variant carriers (homozygous for 192, 194, or 192/194 bp genotypes), and variant carriers. Results: During a median follow-up of 8.8 years, 396 out of the 668 patients with type 2 diabetes (59.3%) died of various causes. The frequency of type 2 diabetes variant carrier and non-variant carriers was 28.7 and 71.3% respectively. The survival in patients with type 2 diabetes without an MI did not differ between the IGF-I genotype groups (hazard ratio (HR) = 0.8, 95% confidence interval (CI): 0.7–1.1, P = 0.1). In contrast, in those who developed an MI, variant carriers had a 2.4 times higher risk of mortality than non-variant carriers (95% CI: 1.2–4.8, P = 0.01). Conclusion: Our study suggests that genetically determined low IGF-I activity is an important determinant of survival in patients with type 2 diabetes who developed an MI. The IGF-I promoter polymorphism, therefore, may help to predict the future mortality risk in this group of patients.

scholarly journals Interaction between the BDNF gene Val/66/Met polymorphism and morning cortisol levels as a predictor of depression in adult women

2012 ◽  
Vol 201 (4) ◽  
pp. 313-319 ◽  
Author(s):  
J. Herbert ◽  
M. Ban ◽  
G. W. Brown ◽  
T. O. Harris ◽  
A. Ogilvie ◽  
...  
Keyword(s):  
Major Depression ◽  
Life Events ◽  
Salivary Cortisol ◽  
Adult Women ◽  
Common Genetic Variants ◽  
Morning Cortisol ◽  
Cortisol Levels ◽  
Depressive Episodes ◽  
Severe Life Events

BackgroundCommon genetic variants, such as the brain-derived neurotrophic factor (BDNF) Val/66/Met polymorphism (rs6265), are known to interact with environmental factors such as early adversity to increase the risk of subsequent major depression. Much less is known about how they interact with individual differences in cortisol, although these also represent a risk for major depression.AimsTo determine whether this BDNF variant moderated the risk represented by higher levels of morning salivary cortisol in adult women.MethodWe recruited 279 premenopausal women who were at high risk of major depressive disorder because of either negative self-evaluation, unsupportive core relationship or chronic subclinical symptoms of depression or anxiety. Morning salivary cortisol was measured daily for up to 10 days at entry. Participants were followed up for about 12 months by telephone calls at 3–4 monthly intervals. Major depression and severe life events were assessed through interviews at baseline and follow-up; DNA was obtained from the saliva.ResultsThere were 53 onsets (19%) of depressive episodes during follow-up. There was a significant U-shaped relationship between adjusted morning cortisol levels at baseline and the probability of depression onset during follow-up. In total, 51% experienced at least one severe life event/difficulty, and this strongly predicted subsequent onsets of depressive episodes. The BDNF Val/66/Met genotype was not directly associated with onsets of depression or with cortisol levels, but there was significant interaction between Val/66/Met and cortisol: the association between baseline cortisol and depression was limited to those with the Val/66/Val variant. There was no interaction between life events and either this BDNF polymorphism or cortisol levels.ConclusionsMorning salivary cortisol interacts with the BDNF Val/66/Met polymorphism in predicting new depressive episodes. This paper adds to the evidence that single gene polymorphisms interact with endogenous factors to predict depression.

Which antidepressants are associated with increased risk of developing mania? A retrospective electronic case register cohort study

2016 ◽  
Vol 33 (S1) ◽  
pp. s228-s229
Author(s):  
R. Patel ◽  
P. Reiss ◽  
H. Shetty ◽  
M. Broadbent ◽  
R. Stewart ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cox Regression ◽  
Antidepressant Treatment ◽  
Multivariable Analysis ◽  
Unipolar Depression ◽  
Antidepressant Therapy ◽  
Case Register ◽  
Cox Regression Analysis ◽  
Increased Risk

IntroductionThe symptoms of bipolar disorder are sometimes misrecognised for unipolar depression and inappropriately treated with antidepressants. This may be associated with increased risk of developing mania. However, the extent to which this depends on what type of antidepressant is prescribed remains unclear.AimsTo investigate the association between different classes of antidepressants and subsequent onset of mania/bipolar disorder in a real-world clinical setting.MethodsData on prior antidepressant therapy were extracted from 21,012 adults with unipolar depression receiving care from the South London and Maudsley NHS Foundation Trust (SLaM). multivariable Cox regression analysis (with age and gender as covariates) was used to investigate the association of antidepressant therapy with risk of developing mania/bipolar disorder.ResultsIn total, 91,110 person-years of follow-up data were analysed (mean follow-up: 4.3 years). The overall incidence rate of mania/bipolar disorder was 10.9 per 1000 person-years. The peak incidence of mania/bipolar disorder was seen in patients aged between 26 and 35 years (12.3 per 1000 person-years). The most frequently prescribed antidepressants were SSRIs (35.5%), mirtazapine (9.4%), venlafaxine (5.6%) and TCAs (4.7%). Prior antidepressant treatment was associated with an increased incidence of mania/bipolar disorder ranging from 13.1 to 19.1 per 1000 person-years. Multivariable analysis indicated a significant association with SSRIs (hazard ratio 1.34, 95% CI 1.18–1.52) and venlafaxine (1.35, 1.07–1.70).ConclusionsIn people with unipolar depression, antidepressant treatment is associated with an increased risk of subsequent mania/bipolar disorder. These findings highlight the importance of considering risk factors for mania when treating people with depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Respiratory Complications in Outpatient Endoscopy with Endoscopist-Directed Sedation

2014 ◽  
Vol 23 (3) ◽  
pp. 255-259 ◽  
Author(s):  
Kilian Friedrich ◽  
Sabine G. Scholl ◽  
Sebastian Beck ◽  
Daniel Gotthardt ◽  
Wolfgang Stremmel ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Respiratory Infection ◽  
Endoscopic Procedure ◽  
Shortness Of Breath ◽  
Respiratory Complications ◽  
Endoscopic Procedures ◽  
Increased Risk ◽  
High Incidence ◽  
Respiratory Complaints

Background & Aims: Respiratory complications represent an important adverse event of endoscopic procedures. We screened for respiratory complications after endoscopic procedures using a questionnaire and followed-up patients suggestive of respiratory infection.Method: In this prospective observational, multicenter study performed in Outpatient practices of gastroenterology we investigated 15,690 patients by questionnaires administered 24 hours after the endoscopic procedure.Results: 832 of the 15,690 patients stated at least one respiratory symptom after the endoscopic procedure: 829 patients reported coughing (5.28%), 23 fever (0.15%) and 116 shortness of breath (SOB, 0.74%); 130 of the 832 patients showed at least two concomitant respiratory symptoms (107 coughing + SOB, 17 coughing + fever, 6 coughing + coexisting fever + SOB) and 126 patients were followed-up to assess their respiratory complaints. Twenty-nine patients (follow-up: 22.31%, whole sample: 0.18%) reported signs of clinically evident respiratory infection and 15 patients (follow-up: 11.54%; whole sample: 0.1%) received therefore antibiotic treatment. Coughing or vomiting during the endoscopic procedure resulted in a 156.12-fold increased risk of respiratory complications (95% CI: 67.44 - 361.40) and 520.87-fold increased risk of requiring antibiotic treatment (95% CI: 178.01 - 1524.05). All patients of the follow-up sample who coughed or vomited during endoscopy developed clinically evident signs of respiratory infection and required antibiotic treatment while this occurred in a significantly lower proportion of patients without these symptoms (17.1% and 5.1%, respectively).Conclusions: We demonstrated that respiratory complications following endoscopic sedation are of comparably high incidence and we identified major predictors of aspiration pneumonia which could influence future surveillance strategies after endoscopic procedures.

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