scholarly journals The Role of the Gut Microbiota in the Development and Progression of Major Depressive and Bipolar Disorder

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 37
Author(s):  
Tom Knuesel ◽  
M. Hasan Mohajeri
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Gut Microbiota ◽  
Intestinal Microbiota ◽  
Treatment Options ◽  
Twin Studies ◽  
Adjunctive Treatment ◽  
Major Depressive ◽  
Response Parameter ◽  
Health Promoting

A growing number of studies in rodents indicate a connection between the intestinal microbiota and the brain, but comprehensive human data is scarce. Here, we systematically reviewed human studies examining the connection between the intestinal microbiota and major depressive and bipolar disorder. In this review we discuss various changes in bacterial abundance, particularly on low taxonomic levels, in terms of a connection with the pathophysiology of major depressive and bipolar disorder, their use as a diagnostic and treatment response parameter, their health-promoting potential, as well as novel adjunctive treatment options. The diversity of the intestinal microbiota is mostly decreased in depressed subjects. A consistent elevation of phylum Actinobacteria, family Bifidobacteriaceae, and genus Bacteroides, and a reduction of family Ruminococcaceae, genus Faecalibacterium, and genus Roseburia was reported. Probiotics containing Bifidobacterium and/or Lactobacillus spp. seemed to improve depressive symptoms, and novel approaches with different probiotics and synbiotics showed promising results. Comparing twin studies, we report here that already with an elevated risk of developing depression, microbial changes towards a “depression-like” microbiota were found. Overall, these findings highlight the importance of the microbiota and the necessity for a better understanding of its changes contributing to depressive symptoms, potentially leading to new approaches to alleviate depressive symptoms via alterations of the gut microbiota.

scholarly journals Effect of Lacticaseibacillus paracasei Strain Shirota on Improvement in Depressive Symptoms, and Its Association with Abundance of Actinobacteria in Gut Microbiota

2021 ◽  
Vol 9 (5) ◽  
pp. 1026
Author(s):  
Machiko Otaka ◽  
Hiroko Kikuchi-Hayakawa ◽  
Jun Ogura ◽  
Hiroshi Ishikawa ◽  
Yukihito Yomogida ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Gut Microbiota ◽  
Intestinal Permeability ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Daily Intake ◽  
Probiotic Strain ◽  
Major Depressive ◽  
Colony Forming Units ◽  
And Biological Markers

We previously reported lower counts of lactobacilli and Bifidobacterium in the gut microbiota of patients with major depressive disorder (MDD), compared with healthy controls. This prompted us to investigate the possible efficacy of a probiotic strain, Lacticaseibacillus paracasei strain Shirota (LcS; basonym, Lactobacillus casei strain Shirota; daily intake of 8.0 × 1010 colony-forming units), in alleviating depressive symptoms. A single-arm trial was conducted on 18 eligible patients with MDD or bipolar disorder (BD) (14 females and 4 males; 15 MDD and 3 BD), assessing changes in psychiatric symptoms, the gut microbiota, and biological markers for intestinal permeability and inflammation, over a 12-week intervention period. Depression severity, evaluated by the Hamilton Depression Rating Scale, was significantly alleviated after LcS treatment. The intervention-associated reduction of depressive symptoms was associated with the gut microbiota, and more pronounced when Bifidobacterium and the Atopobium clusters of the Actinobacteria phylum were maintained at higher counts. No significant changes were observed in the intestinal permeability or inflammation markers. Although it was difficult to estimate the extent of the effect of LcS treatment alone, the results indicated that it was beneficial to alleviate depressive symptoms, partly through its association with abundance of Actinobacteria in the gut microbiota.

Emotional availability in women with bipolar disorder and major depression: A longitudinal pregnancy cohort study

2021 ◽  
pp. 000486742199879
Author(s):  
Pavitra Aran ◽  
Andrew J Lewis ◽  
Stuart J Watson ◽  
Thinh Nguyen ◽  
Megan Galbally
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Depressive Disorder ◽  
Emotional Availability ◽  
Major Depressive ◽  
Interaction Quality ◽  
Pregnancy Cohort ◽  
The Impact

Objective: Poorer mother–infant interaction quality has been identified among women with major depression; however, there is a dearth of research examining the impact of bipolar disorder. This study sought to compare mother–infant emotional availability at 6 months postpartum among women with perinatal major depressive disorder, bipolar disorder and no disorder (control). Methods: Data were obtained for 127 mother–infant dyads from an Australian pregnancy cohort. The Structured Clinical Interview for the DSM-5 was used to diagnose major depressive disorder ( n = 60) and bipolar disorder ( n = 12) in early pregnancy (less than 20 weeks) and review diagnosis at 6 months postpartum. Prenatal and postnatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, along with self-report psychotropic medication use. Mother and infant’s interaction quality was measured using the Emotional Availability Scales when infants reached 6 months of age. Multivariate analyses of covariance examining the effects of major depressive disorder and bipolar disorder on maternal emotional availability (sensitivity, structuring, non-intrusiveness, non-hostility) and child emotional availability (responsiveness, involvement) were conducted. Results: After controlling for maternal age and postpartum depressive symptoms, perinatal disorder (major depressive disorder, bipolar disorder) accounted for 17% of the variance in maternal and child emotional availability combined. Compared to women with major depressive disorder and their infants, women with bipolar disorder and their infants displayed lower ratings across all maternal and child emotional availability qualities, with the greatest mean difference seen in non-intrusiveness scores. Conclusions: Findings suggest that perinatal bipolar disorder may be associated with additional risk, beyond major depressive disorder alone, to a mother and her offspring’s emotional availability at 6 months postpartum, particularly in maternal intrusiveness.

scholarly journals Polygenic scores for major depressive disorder and depressive symptoms predict response to lithium in patients with bipolar disorder

2018 ◽  
Author(s):  
Azmeraw T. Amare ◽  
Klaus Oliver Schubert ◽  
Liping Hou ◽  
Scott R. Clark ◽  
Sergi Papiol ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Treatment Response ◽  
Lithium Treatment ◽  
Mapk Signaling ◽  
Genome Wide Association Studies ◽  
Major Depressive ◽  
Polygenic Scores

AbstractBackgroundLithium is a first-line medication for bipolar disorder (BD), but only ~30% of patients respond optimally to the drug. Since genetic factors are known to mediate lithium treatment response, we hypothesized whether polygenic susceptibility to the spectrum of depression traits is associated with treatment outcomes in patients with BD. In addition, we explored the potential molecular underpinnings of this relationship.MethodsWeighted polygenic scores (PGSs) were computed for major depressive disorder (MDD) and depressive symptoms (DS) in BD patients from the Consortium on Lithium Genetics (ConLi+Gen; n=2,586) who received lithium treatment. Lithium treatment outcome was assessed using the ALDA scale. Summary statistics from genome-wide association studies (GWAS) in MDD (130,664 cases and 330,470 controls) and DS (n=161,460) were used for PGS weighting. Associations between PGSs of depression traits and lithium treatment response were assessed by binary logistic regression. We also performed a cross-trait meta-GWAS, followed by Ingenuity® Pathway Analysis.OutcomesBD patients with a low polygenic load for depressive traits were more likely to respond well to lithium, compared to patients with high polygenic load (MDD: OR =1.64 [95%CI: 1.26-2.15], lowest vs highest PGS quartiles; DS: OR=1.53 [95%CI: 1.18-2.00]). Associations were significant for type 1, but not type 2 BD. Cross-trait GWAS and functional characterization implicated voltage-gated potassium channels, insulin-related pathways, mitogen-activated protein-kinase (MAPK) signaling, and miRNA expression.InterpretationGenetic loading to depression traits in BD patients lower their odds of responding optimally to lithium. Our findings support the emerging concept of a lithium-responsive biotype in BD.FundingSee attached details

Brexpiprazole in the treatment of schizophrenia and agitation in Alzheimer’s disease

2020 ◽  
Vol 10 (4) ◽  
pp. 205-217 ◽  
Author(s):  
Lauren Stummer ◽  
Marija Markovic ◽  
Megan Maroney
Keyword(s):  
Daily Living ◽  
Partial Agonist ◽  
Treatment Options ◽  
Unmet Need ◽  
Adjunctive Treatment ◽  
Metabolic Disturbances ◽  
Major Depressive ◽  
The Us ◽  
Us Fda ◽  
The Eu

Schizophrenia is a disabling psychiatric disorder marked by progressive loss of functionality in activities of daily living with each relapse. Antipsychotics, the mainstay of therapy for schizophrenia, treat hallucinations and delusions but may have intolerable side effects, including metabolic disturbances and extrapyramidal symptoms. Brexpiprazole, a second-generation antipsychotic with dopamine partial agonist properties, was approved by the US FDA in 2015 for the treatment of schizophrenia and adjunctive treatment of major depressive disorder and by the EU in 2018 for adults with schizophrenia. Additionally, brexpiprazole has recently been studied for the treatment of agitation in Alzheimer’s dementia, an area of largely unmet need. Overall, well-tolerated brexpiprazole expands the armamentarium of treatment options available for these conditions.

Ketamina, un nuevo agente terapéutico para la depresión

2020 ◽  
Vol 63 (1) ◽  
pp. 6-13 ◽  
Author(s):  
Rodrigo Pérez-Esparza ◽  
Luis Fabián Kobayashi-Romero ◽  
Ana María García Mendoza ◽  
Reyna Minerva Lamas-Aguilar ◽  
Melissa Vargas Sosa ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Treatment Options ◽  
Current Treatment ◽  
Mechanisms Of Action ◽  
Key Words Depression ◽  
Major Depressive ◽  
Factors Associated ◽  
Rapid Action ◽  
Treatment Of Depression

Major depressive disorder affects about one in every 10 people in Mexico and is one of the first 5 causes of disability worldwide. Current treatment options are limited and only act upon some factors associated in its physiopathology. Moreover, the effects on depression are not immediate, which is a great limitation in obtaining a benefit over disability caused by this disorder and impedes a rapid action in the scenario of suicidality. Recently, ketamine (an anesthetic) has shown to have antidepressant properties by acting in the glutamate neurotransmission system (while no other current treatment acts on this level). It offers benefits in depressive symptoms in a matter of hours and has proven to be useful in patients that do not benefit from current therapeutic options. Recently, it has been approved for the treatment of depression. However, there are still many questions about its antidepressant mechanisms of action, safety, side effects, among others. Key words: Depression; antidepressants; ketamine.

The Quick Inventory of Depressive Symptomatology (Clinician and Self-Report Versions) in Patients With Bipolar Disorder

CNS Spectrums ◽  
2010 ◽  
Vol 15 (6) ◽  
pp. 367-373 ◽  
Author(s):  
Ira H. Bernstein ◽  
A. John Rush ◽  
Trisha Suppes ◽  
Yakasushi Kyotoku ◽  
Diane Warden
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Depressive Symptomatology ◽  
Self Report ◽  
General Interest ◽  
Major Depressive ◽  
Sad Mood ◽  
Illness Phase

ABSTRACTIntroduction: The clinical and self-report versions of the Quick Inventory of Depressive Symptomatology (QIDS-C16 and QIDS-SR16) have been well studied in patients with major depressive disorder and in one recent study using patients with bipolar disorder. This article examines these measures in a second sample of 141 outpatients with bipolar disorder in different phases of the illness.Methods: At baseline, 61 patients were depressed and 30 were euthymic; at exit, 50 were depressed and 52 were euthymic. The remaining patients (at baseline or exit) were in either a manic or mixed phase and were pooled for statistical reasons.Results: Similar results were found for the QIDS-C16 and QIDS-SR16. Scores were reasonably reliable to the extent that variability within groups permitted. As expected, euthymic patients showed less depressive symptomatology than depressed patients. Sad mood and general interest were tne most discriminating symptoms between depressed and euthymic phases. Changes in illness phase (baseline to exit) were associated with substantial changes in scores. The relation of individual depressive symptoms to the overall level of depression was consistent across phases.Conclusion: Both the QIDS-SR16 and QIDS-C16 are suitable measures of depressive symptoms in patients with bipolar disorder.

scholarly journals Homicide attempt due to medication induced mania

2021 ◽  
Author(s):  
Jordan Berry ◽  
Naghmeh Mokhber ◽  
Arun Prakash ◽  
Ajay Prakash ◽  
Julie Zamprogna
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Mental Disorders ◽  
Bipolar Depression ◽  
Bipolar Disorders ◽  
Depressive State ◽  
Major Depressive ◽  
Difficult Situation ◽  
Serotonergic Antidepressant

Bipolar disorders are a group of mental disorders characterized by fluctuations in mood, with depressive symptoms generally dominating the course of disorder. Research on the efficacy of serotonergic antidepressants in bipolar depression is controversial and as a result, treatment of depressive symptoms in bipolar disorder is difficult. A particularly difficult situation arises when bipolar disorder is unrecognized and the depressive state is treated as major depressive disorder with the use of serotonergic antidepressants, which can result in the phenomenon of antidepressant induced mania (AIM). In this report, we present a case of antidepressant induced mania (AIM) with homicidal ideation after initiation of serotonergic antidepressants. Here, we discuss the importance of monitoring for bipolar disorder after prescribing serotonergic antidepressant therapy as well as medico-legal considerations.

Misdiagnose bipolar disorder: About a case report

2017 ◽  
Vol 41 (S1) ◽  
pp. S425-S425
Author(s):  
C. Novais ◽  
M. Marinho ◽  
M. Mota Oliveira ◽  
M. Bragança ◽  
A. Côrte-Real ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Psychiatric Inpatient ◽  
Bipolar Disorders ◽  
Manic Episode ◽  
Inpatient Unit ◽  
Cranial Computed Tomography ◽  
Major Depressive ◽  
Competing Interest

IntroductionEarly stages of bipolar disorder are sometimes misdiagnosed as depressive disorders. This symptomatology can lead to misinterpretation and under diagnosis of bipolar disorders.Objectives/aimsTo describe a patient with a new diagnosis of bipolar disorder after 23 years of psychiatric care.MethodsWe report a case of a 66-year-old man, with a previous psychiatric diagnosis of recurrent depressive disorder for the last 23 years, after a hospitalization in a psychiatric inpatient unit because of a major depressive episode. In subsequent years, he was regularly followed in psychiatric consultation with description of recurrent long periods of depressed mood requiring therapeutic setting, alternating with brief remarks of not valued slightly maladjusted behaviour. At 65, he came to the emergency room presenting with observable expansive and elevated mood, disinhibited behaviour, grandiose ideas and overspending, leading to his hospitalization with the diagnosis of a manic episode. In the inpatient unit care, we performed blood tests, cranial-computed tomography (CT) and a cognitive assessment. His medication has also been adjusted.ResultsLaboratory investigations were unremarkable. Cranial-CT showed some subcortical atrophy of frontotemporal predominance, without corroboration by the neuropsychological evaluation. The patient was posteriorly transferred to a residential unit for stabilization, where he evolved with major depressive symptoms that needed new therapeutic adjustment. Later he was discharged with the diagnosis of bipolar disorder.ConclusionsOur case elucidates the importance of ruling out bipolar disorder in patients presenting with depressive symptoms alternating with non-specific maladjusted behaviour, which sometimes can be a challenging task.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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