Irritable bowel syndrome (IBS) has been associated with high prevalence of psychological disorders. However, it remains unclear whether IBS and each of its subtypes (predominant diarrhea IBS-D, constipation IBS-C, mixed IBS-M) are associated with higher anxiety and depressive symptoms levels. This study aimed to determine the associations of IBS and each of its subtypes with anxiety and/or depression. We conducted a systematic review and meta-analysis using five electronic databases (PubMed, PsychINFO, BIOSIS, Science Direct, and Cochrane CENTRAL). We selected case-control studies comparing anxiety and depression levels of patients with IBS to healthy controls, using standardized rating scales. Outcomes were measured as random pooled standardized mean differences (SMD). Ten studies were included in our analysis (885 patients and 1,384 healthy controls). Patients with IBS had significant higher anxiety and depression levels than controls (respectively, SMD = 0.76, 95 % CI 0.47; 0.69, p < 0.01, I2 = 81.7 % and SMD = 0.80, 95 % CI 0.42; 1.19, p < 0.01, I2 = 90.7 %). This significant difference was confirmed for patients with IBS-C and -D subtypes for anxiety, and only in IBS-D patients for depression. However, other IBS subtypes had a statistical trend to be associated with both anxiety and depressive symptomatology, which suggests a lack of power due to the small number of studies included. Patients with IBS had significantly higher levels of anxiety and depression than healthy controls. Anxiety and depression symptomatology should be systematically checked and treated in IBS patients, as psychological factors are important moderators of symptom severity, symptom persistence, decisions to seek treatment, and response to treatment.
The present meta-analysis confirms ketamine's efficacy in depressive disorders in non-ECT studies, as well as in ECT studies. The results of this first meta-analysis are encouraging, and further studies are warranted to detail efficacy in bipolar disorders and other specific depressed populations. Middle- and long-term efficacy and safety have yet to be explored. Extrapolation should be cautious: Patients included had no history of psychotic episodes and no history of alcohol or substance use disorders, which is not representative of all the depressed patients that may benefit from this therapy.
Given that in vivo telomere length reflects cellular turnover and exposure to oxidative and inflammatory damage, our data support accelerated aging in COPD.
To date, it remains impossible to guarantee that short-term treatment given to a patient
suffering from a major depressive episode (MDE) will improve long-term efficacy. Objective
biological measurements and biomarkers that could help in predicting the clinical
evolution of MDE are still warranted. To better understand the reason nearly half of MDE
patients respond poorly to current antidepressive treatments, we examined the gene
expression profile of peripheral blood samples collected from 16 severe MDE patients and
13 matched controls. Using a naturalistic and longitudinal design, we ascertained mRNA and
microRNA (miRNA) expression at baseline, 2 and 8 weeks later. On a genome-wide scale, we
detected transcripts with roles in various biological processes as significantly
dysregulated between MDE patients and controls, notably those involved in nucleotide
binding and chromatin assembly. We also established putative interactions between
dysregulated mRNAs and miRNAs that may contribute to MDE physiopathology. We selected a
set of mRNA candidates for quantitative reverse transcriptase PCR (RT-qPCR) to validate
that the transcriptional signatures observed in responders is different from
nonresponders. Furthermore, we identified a combination of four mRNAs (PPT1,
TNF, IL1B and HIST1H1E) that could be predictive of treatment
response. Altogether, these results highlight the importance of studies investigating the
tight relationship between peripheral transcriptional changes and the dynamic clinical
progression of MDE patients to provide biomarkers of MDE evolution and prognosis.
Meta-analyses and reviews on cognitive disorders in schizophrenia have shown that the most robust and common cognitive deficits are found in episodic memory and executive functions. More complex memory domains, such as autobiographical memory (AM), are also impaired in schizophrenia, but such impairments are reported less often despite their negative impact on patients' outcome. In contrast to episodic memory, assessed in laboratory tasks, memories of past personal events are much more complex and directly relate to the self. The meta-analysis included 20 studies, 571 patients with schizophrenia spectrum disorder, and 503 comparison subjects. It found moderate-to-large effect sizes with regard to the 3 parameters commonly used to assess AM: memory specificity (g = −0.97), richness of detail (g = −1.40), and conscious recollection (g = −0.62). These effect sizes were in the same range as those found in other memory domains in schizophrenia; for this reason, we propose that defective memories of personal past events should be regarded as a major cognitive impairment in this illness.
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