Influence of Clinical Markers of Dopaminergic Behaviors on Depressive Symptoms During Withdrawal in Cocaine Users

Background: During cocaine withdrawal, transient depressive symptoms that do not meet the criteria for depression, but promote relapse, are frequently observed. Their temporality could evoke a role of dopamine, especially since the underlying mechanism of these depressive symptoms is not well understood. We hypothesized that variation in the dopaminergic activity profile, modeled from clinical markers, could be implicated in the development of depressive symptoms during cocaine withdrawal.Methods: We compared patients reporting depressive symptoms (RDS+) or not (RDS–) during cocaine withdrawal. We evaluated dopaminergic activity through indirect clinical markers based on the known dopaminergic behaviors. A combined criterion was constructed for hyper and hypo dopaminergic models according to the O'Brien method and illustrated by the Hedges' effect-size and forest-plot graph. A multidimensional factorial analysis was carried out to determine which parameters discriminate RDS+/RDS– patients.Results: 313 patients were included, and 77% reported depressive symptoms during cocaine withdrawal. Hyperdopaminergic variables used to discriminate the two groups had a large overall effect size (−0.669) and included psychotic symptoms (−0.524), hallucinations (−0.548), and delusions (−0.528). The overall effect of the hypodopaminergic component was considerable (−0.604) with a large effect size for the severity of dependence (−0.616), withdrawal symptoms (−0.578), and anhedonia (−0.528). The combined model including hyperdopaminergic and hypodopaminergic components had the largest effect size (−0.785).Conclusion: The dopaminergic activities profile, assessed by indirect clinical markers, seems to characterize patients with depressive symptoms very well during cocaine withdrawal. RDS+ patients reported moreover higher levels of psychotic symptoms and more severe cocaine use disorder than RDS–.

Download Full-text

Quality of life in individuals with attenuated psychotic symptoms: Possible role of anxiety, depressive symptoms, and socio-cognitive impairments

Psychiatry Research ◽

10.1016/j.psychres.2017.08.024 ◽

2017 ◽

Vol 257 ◽

pp. 431-437 ◽

Cited By ~ 12

Author(s):

Tsutomu Takahashi ◽

Yuko Higuchi ◽

Yuko Komori ◽

Shimako Nishiyama ◽

Mihoko Nakamura ◽

...

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Cognitive Impairments ◽

Psychotic Symptoms

Download Full-text

The role of perceived discrimination in mediating the relationship between minority status and psychotic symptoms in a community sample

Konselor ◽

10.24036/0201983105924-0-00 ◽

2020 ◽

Vol 8 (4) ◽

Author(s):

Eko Hermanto ◽

Sali Rahadi Asih ◽

Edo Sebastian Jaya

Keyword(s):

Negative Symptoms ◽

Minority Groups ◽

Perceived Discrimination ◽

Community Sample ◽

Underlying Mechanism ◽

Psychotic Symptoms ◽

Minority Status ◽

Social Stressors ◽

The Relationship

Minority groups have been found to be at higher risk of developing psychotic symptoms, but the underlying mechanism is yet to be established. This study aims to determine the mechanism that underlies the relationship between minority status and psychotic symptoms, investigating the role of perceived discrimination as a mediator. We assessed 387 participants from a community sample in Indonesia using the Community Assessment of Psychotic Experiences for psychotic symptoms, surveys adapted from the NEMESIS study for minority status and perceived discrimination, and controlled for depression with the Patient Health Questionnaire-9. Mediation analysis was conducted, which showed that perceived discrimination fully mediated the relationship between minority status and positive psychotic symptoms, but not negative psychotic symptoms. This finding supports the social defeat hypothesis, which states that social stressors lead to positive psychotic symptoms due to dopamine dysregulation. However, further research is required to illustrate the association between social stressors and negative symptoms.

Download Full-text

S22. SPECIFIC PSYCHOTIC EXPERIENCES AND DEPRESSIVE SYMPTOMS IN CHILEAN ADOLESCENTS: A MULTIPLE MEDIATION MODEL OF THEIR IMPACT ON SUICIDAL IDEATION

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.088 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S38-S39

Author(s):

Daniel Nunez ◽

Susana Campos ◽

Rosario Spencer ◽

María Faúndez ◽

Andrés Fresno ◽

...

Keyword(s):

Depressive Symptoms ◽

Suicidal Ideation ◽

Young People ◽

Suicidal Behavior ◽

Psychotic Symptoms ◽

Psychotic Experiences ◽

Mediation Model ◽

Multiple Mediation ◽

Mediation Analyses

Abstract Background Adolescence is a critical period for the emergence of psychopathology and risk behaviors, including psychotic symptoms and suicidal behavior. Literature has shown that psychotic experiences (PE) are associated with increased odds of suicidal ideation (SI) and attempts in young people. PE are normally regarded as subthreshold positive symptoms, and have been clustered in three domains: persecutory ideation (PI), bizarre experiences (BE) and perceptual abnormalities (PA). All of these domains have been linked to depression, and recent studies demonstrated that, in young people, perceptual abnormalities and persecutory ideation are associated with a higher risk of suicidality, instead, while bizarre experiences were not. Nevertheless, how specific PEs are associated to suicidal is not clearly understood, and the role of common risk factors in this link, such as depressive symptoms (DS), remains controversial. Thus, the aim of this study was to explore the underlying mechanisms linking specific PEs and SI. Methods 1708 Chilean school adolescents aged 13–19 (M=15.68 + 1.67, women= 39%) answered an online screening aimed at detecting mental health symptoms between May and October 2019. The screening is composed of several questionnaires adapted for Chilean samples, including the Columbia-suicide Severity Rating Scale (CSSRS), the Patient Health Questionnaire (PHQ-9), and the Community Assessment for Psychic Experiences (CAPE-P15). Informed consent was granted by the parents and caregivers of all school adolescents. We conducted mediation analyses with the PROCESS statistical package, which runs regression-based mediations through a 5000 bootstrap resampling to estimate confidence intervals. Results Significant association were found among all variables in the study (SI-DS: r= .624, p<.001; PI-SI: r= .495, p<.001; PA-SI= .391, p<.001; PI-DS: r= .660, p<.001; PI-DS: r= .429, p<.001; PI-PA: r= .442, p<.001), except for BE with SI and SD. No demographic variables were correlated significantly to the dependent variable, thus these were controlled for in the mediation analyses. In the multiple mediation model, the link between abnormal perceptions and suicidal ideation is mediated by both persecutory ideation (PI) and depressive symptoms (DS) (b= .1278, 95% BCa CI [.1044, .1526]). Moreover, PI mediates the association between perceptual abnormalities (PA) and DS (b= .0494, 95% BCa CI [.0234, .0769], and DS mediates the link between PI and SI (b= .084, 95% BCa CI [.0596, .1077]). When the mediators were not included in the model, PA significantly predicted SI (b = .361, t = 17.55, p < 0.001). Two additional models were carried out using separate PA (auditory and visual hallucinations) as the predictor variables. In model 1, the link between visual PA and SI was mediated by both PI and DS (b= .1087, 95% BCa CI [.0874, .1326]). A significant indirect effect was also found in model 2, regarding auditory PA (b= .1175, 95% BCa CI [.0933, .1435]). Discussion Our findings highlights the underlying role of DS along with specific types of PEs, particularly with PI, as the pathway to SI. The consistency of the significant, yet small indirect effects in all three mediations, could indicate a relative robustness in the model. Our findings could suggest that depression does not influence suicidal behavior independently, but rather, it interacts with other psychopathological elements, such as PI, to influence the development of suicidal ideation. This supports literature stating that any aspect of the suicide continuum is the result of a complex interplay between numerous contributing psychosocial factors.

Download Full-text