Causes of drug discontinuation in patients with major depressive disorder in China

Objective: Neuroendocrine dysfunction is related to the pathogenesis of mental disorders, but conclusions from clinical research lack consistency. We aimed to investigate the neuroendocrinal pathophysiology and its correlation with clinical symptoms in patients with schizophrenia. Methods:The present cross-sectional study included 486 inpatients with schizophrenia admitted at a psychiatric hospital in Shanghai within one year, and 154 healthy controls (HC) matched on age and gender. The serum hemoconcentrations of thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), adrenocorticotrophic hormone (ACTH), and cortisol (COR) were measured via electrochemical luminescence immunoassay. Pathophysiological conversions of neuroendocrine were then associated with gender, age, age at onset, antipsychotic treatment using hierarchical multiple linear regression.Results: When compared to HC, the schizophrenia group showed elevated ACTH and COR levels and decreased TT3 and TT4 levels (p's < 0.05). First-episode patients showed lower TSH and higher FT3 and FT4 (p's < 0.05) compared to recurrent patients. Female patients showed higher TSH and lower TT3, FT3, and ACTH levels (p's < 0.05) compared to males. We observed the area under the curve (AUC) of the predictive model to distinguish between schizophrenia and HC to be 0.737 among total samples and between first-episode and recurrent schizophrenia to be 0.890 among subgroups.Conclusions: Decreased TT3 and TT4 and elevated ACTH and COR levels appear to be associated with schizophrenia symptoms. The chronic recurrent trait of schizophrenia Frontiers in Psychiatry | www.frontiersin.org

Section: Discussionmentioning

confidence: 99%

Functional Status of Hypothalamic–Pituitary–Thyroid and Hypothalamic–Pituitary–Adrenal Axes in Hospitalized Schizophrenics in Shanghai

Zhu

Tao

et al. 2020

Front. Psychiatry

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“…Other than that, for a more detailed discussion on the olfactory function in depression, more influenced factors can be taken into consideration, such as gender, the severity of depression, course and duration of depression. Moreover, though the follow-up subjects had clear curative effects, patients with refractory depression or poor treatment compliance 48 hardly can be included in real-world study even when they do meet the inclusion and exclusion criteria, which needs to be considered in the high-quality design.…”

Section: Discussionmentioning

confidence: 99%

Association between olfactory function and inhibition of emotional competing distractors in major depressive disorder

Jin

et al. 2020

Sci Rep

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We aimed to investigate the changes of olfaction of major depressive disorder (MDD) before and after medical treatment, and to preliminarily scrutinize the association between the olfactory function and the severity of depressive symptoms, response inhibition, and emotional responding. Forty-eight medicine-naïve MDD patients plus 33 healthy controls (HC) matched on gender, ages, and level of education, were recruited in the test group. The Chinese Smell Identification Test (CSIT), Self-reported Olfactory Scale (SROS), 17-item Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), and mean reaction time/accuracy rate (ΔMRt) of emotional Stroop test were measured. The patients were assessed before the treatment (baseline) and 3 months after the treatment (follow-up). The data at the baseline level were measured then associated using multiple linear regression stepwise analysis. The MDD patients had lower scores of the CSIT and SROS and longer ΔMRt at baseline level compared to Hc while the ΔMRt of MDD patients remained longer after 3-month treatment (p's < 0.05). At the baseline level, the regression equation including age and ΔMRt of negative word-color congruent (NEG-C), was finally observed as follows: y(CSIT) = 10.676-0.063 × 1-0.002 × 2, [x 1 = the age(y), x 2 = the NEG-C (ms)]. The olfactory function of MDD appears to be correlated negatively with the age and the ΔMRT of negative stimuli before treatment. After the remission of MDD, the olfactory dysfunction was improved, which might be regarded as a responding phenotype of brain function of MDD rather than the emotional responding. Major depressive disorder (MDD) and olfaction disorder (OD) are both chronic diseases that affect human being's life quality 1. A systematic review on ten studies chosen for using the Sniffin' Sticks Test and the 40-item Smell Identification Test assessed to reveal the relationship between depression and OD. Results show that both of the olfactory threshold, olfactory discrimination, and olfactory identification were influenced by depression 2. Furthermore, symptoms of depression worsen with the severity of olfactory loss 3. It was demonstrated that olfactory bulbectomy, as a well-known method, could induce an animal model of depression in animal experiment 4. In depression-related brain areas including hippocampus, frontal cortex and hypothalamus, the turnover of serotonin and dopamine decreases in the olfactory bulbectomized rats 5. Similarly, in human studies, Cory et al. 6 found that patients with depression have decreased activities in the left medial orbitofrontal cortex (OFC) accompanied with the defect of the olfactory identification. However, Zucco et al. 7 argued that the changes mentioned above occur in patients with the MDD only, not with the mild or moderate depressive disorder. In the neural circuits involved in emotional processing 8 , these key structures such as amygdala, hippocampus, anterior cingulate cortex(ACC) and OFC, are the imperative functional regions of the human olfactory map...

“…All statistical analyses were de ned as two-tailed p values, signi cance level of 5% (α = 0.05). Bonferroni corrections for multiple comparisons were applied, and the level was α = α'/c, c (number of pairwise comparisons) = (k (k − 1)/2) [23]. Hormone hemoconcentrations of the thyroid and PRL Bonferroni correction for multiple comparisons was applied, the level was 0.05/3 = 0.0167.…”

Section: Discussionmentioning

confidence: 99%

Functional Status of Hypothalamic-pituitary-thyroid axis and Prolactin level in Patients with First-episode of Bipolar Disorder in Mania State

Zhang

et al. 2020

Preprint

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Background Bipolar disorder (BD)-mania symptoms are stimulated by disease of the thyroid. Methods This study included 70 patients diagnosed with first-episode BD-mania and 70 healthy controls (HC) matched for age and sex. We aimed to determine upstream thyroid hormone interactions on the anterior pituitary, and find differences between thyroid-stimulating-hormone (TSH) and Prolactin (PRL) in the patients with first-episode of BD-mania. There were significant changes in triiodothyronine (TT3), total thyroxin (TT4), and free thyroxine (FT4) concentrations between the BD-mania and HC groups (p < 0.0167 with Bonferroni correction). Results After being grouped by sex, higher PRL in the male and female BD-mania subgroup were observed compared to each isosexual HC (p’s < 0.01). Higher FT4 in the male BD-mania group was observed compared to the HC males (p < 0.01) while the female BD-mania group showed lower TT3 and TT4 compared to the HC females (p’s < 0.01). In the female BD-mania group, correlation analysis established an inverse relationship between PRL and TSH (r2 = 0.25, F = 11.11, p < 0.01). Conclusions The findings demonstrate that sex impacts the concentration of hormones secreted by the anterior pituitary of patients with first-episode BD-mania. The increased PRL may be a putative mechanism that underlies the onset in female patients with a moderate inverse relationship between TSH and PRL.