Changes in Severity of Allergy and Anxiety Symptoms Are Positively Correlated in Patients with Recurrent Mood Disorders Who Are Exposed to Seasonal Peaks of Aeroallergens

Postolache, Teodor T.; Zimmerman, Sarah A.; Lapidus, Manana; Cabassa, Johanna A.; D’Agostino, Daniele; Langenberg, Patricia; Tonelli, Leonardo H.

doi:10.1016/j.jaci.2008.12.900

Cited by 7 publications

(7 citation statements)

References 49 publications

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“…Observations that elevated levels of inflammatory markers are found in patients with anxiety [ 27 ] and depression [ 28 ], the co-occurrence of anxiety / depression with inflammatory diseases and the increased risk of anxiety / depression with cytokine treatment [ 29 , 30 ] have suggested that increased inflammation is associated with a higher risk of mental health disorders in men. For urinary symptoms, increased systemic inflammation (as reflected most often by higher CRP levels [ 31 ]) has been associated with an increased risk of LUTS.…”

Section: Discussionmentioning

confidence: 99%

Lower Urinary Tract Symptoms, Depression, Anxiety and Systemic Inflammatory Factors in Men: A Population-Based Cohort Study

et al. 2015

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BackgroundThe relationship between lower urinary tract symptoms (LUTS) and common mental health disorders such as depression and anxiety in men remains unclear. Inflammation has recently been identified as an independent risk factor for LUTS and depression. This study aimed to assess the association between depression, anxiety and LUTS, and the moderating influence of systemic inflammation, in the presence of other biopsychosocial confounders.MethodsParticipants were randomly-selected from urban, community-dwelling males aged 35–80 years at recruitment (n = 1195; sample response rate:67.8%). Of these, 730 men who attended baseline (2002–5) and follow-up clinic visits (2007–10), with complete outcome measures, and without prostate or bladder cancer and/or surgery, neurodegenerative conditions, or antipsychotic medications use, were selected for the present study. Unadjusted and multi-adjusted regression models of incident storage and voiding LUTS and incident depression and anxiety were combined with serum inflammatory markers (high-sensitive C-reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-α), interleukin–6 (IL–6), myeloperoxidase (MPO), soluble e-selectin (e-Sel)) and socio-demographic, lifestyle, and health-related factors. Hierarchical multiple regression was used to assessed the moderating effect of inflammatory markers.ResultsThe incidence of storage, voiding LUTS, depression and anxiety was 16.3% (n = 108), 12.1% (n = 88), 14.5% (n = 108), and 12.2% (n = 107). Regression models demonstrated that men with depression and anxiety at baseline were more likely to have incident storage, but not voiding LUTS (OR: 1.26, 99%CI: 1.01–4.02; and OR:1.74; 99%CI:1.05–2.21, respectively). Men with anxiety and storage LUTS at baseline were more likely to have incident depression (OR: 2.77, 99%CI: 1.65–7.89; and OR:1.45; 99%CI:1.05–2.36, respectively), while men with depression and voiding LUTS were more likely to have anxiety at follow-up (OR: 5.06, 99%CI: 2.81–9.11; and OR:2.40; 99%CI:1.16–4.98, respectively). CRP, TNF-α, and e-Sel were found to have significant moderating effects on the development of storage LUTS (1.06, 0.91–1.96, R2 change: 12.7%), depression (1.17, 1.01–1.54, R2 change: 9.8%), and anxiety (1.35, 1.03–1.76, R2 change: 10.6%), respectively.ConclusionsThere is a bidirectional relationship between storage, but not voiding, LUTS and both depression and anxiety. We observed variable moderation effects for selected inflammatory markers on the development of depression, anxiety and storage LUTS.

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Section: Discussionmentioning

confidence: 99%

Lower Urinary Tract Symptoms, Depression, Anxiety and Systemic Inflammatory Factors in Men: A Population-Based Cohort Study

et al. 2015

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“…Our own work in a student population has shown that seasonality of mood is directly related to self-reported sensitivity to pollen counts [8, Class II]. Finally, we have shown that changes in allergy symptoms from low to high tree-pollen seasons correlate with changes in depression scores [9, Class II] and anxiety scores [10, Class II] in patients with recurrent mood disorders.…”

Section: Introductionmentioning

confidence: 96%

Allergy: A risk factor for suicide?

Postolache

Komarow²,

Tonelli³

2008

Curr Treat Options Neurol

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The rates of depression, anxiety, and sleep disturbance (suicide risk factors) are greater in patients with allergic rhinitis than in the general population. The rate of allergy is also greater in patients with depression. Preliminary data suggest that patients with a history of allergy may have an increased rate of suicide. Clinicians should actively inquire to diagnose allergy in patients with depression and depression in patients with allergy.Spring peaks of suicide are highly replicated, but their origin is poorly understood. Preliminary epidemiologic data suggest that seasonal spring peaks in aeroallergens are associated with seasonal spring peaks in suicide. Our research in Brown Norway rats demonstrates that sensitization and exposure to aeroallergens induces anxiety-like and aggressive behaviors as well as allergy-related helper T-cell type 2 (Th2) cytokine gene expression in the prefrontal cortex. Thus, it is possible that sensitization and exposure to aeroallergens, which peak in spring, may be conducive to seasonal exacerbation of suicide risk factors such as anxiety, depression, hostility/ aggression, and sleep disturbance. Connecting allergy with suicide and suicide risk factors adds to previous neurologic literature connecting allergy with migraines and seizure disorders.Our recent report of Th2 (allergy-mediating) cytokine expression in the orbito-frontal cortex of suicide victims should lead to future studies to test the hypothesis that mediators of allergic inflammation in the nasal cavities may result in Th2 cytokine expression in the brain, influencing affect and behavioral modulation.Certain medications used to treat allergy can exacerbate suicide risk factors, potentially worsening suicide risk and even triggering suicide. Systemic (but not topical) corticosteroids have been associated with manic and depressive episodes and mixed mood states. Recently, the US Food and Drug Administration started investigating the possibility that montelukast may trigger suicide. Although this association requires further exploration and confirmation, clinicians should err on the side of caution, inquiring about past suicide attempts; hopelessness; reasons for living; and suicidal ideation, intent, or plan; and referring the patient to a mental health professional for evaluation if appropriate. One of the most dramatic environmental changes, which coincides with physical symptoms, is the robust increase in pollen during the spring and the corresponding increased incidence of upper respiratory inflammation. Pollen is the most important and the most seasonal of the aeroallergens [3, Class III]. Every year, the air is flooded with pollen from wind-pollinated plants, and the development of allergies due to human exposure is an unfortunate consequence of this process. Tree pollination occurs in the spring and represents the largest source of airborne pollen (∼ 75% of the yearly total). As an example of the time window of pollen peaks, we refer to the weekly mean values reported for total pollen production in the B...

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“…7 In addition to these adverse physical and social impacts, a number of studies consistently linked atopy to poor psychological outcomes, including major depression 8,9 and anxiety. 10 A recent systematic review presented a link between asthma and suicidal behaviors 11 ; however, there are no current systematic reviews on the possible association between allergies and suicidal behaviors. Hence, the aim of the current article was to conduct a systematic literature review to explore the potential link between allergies and fatal and nonfatal suicidal behaviors.…”

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confidence: 99%