Vascular Risk Factors and Depression in Later Life: A Systematic Review and Meta-Analysis

Valkanova, Vyara; Ebmeier, Klaus P.

doi:10.1016/j.biopsych.2012.10.028

Cited by 145 publications

(153 citation statements)

References 91 publications

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“…Hypertension is part of a cardiovascular risk profile. Significant bidirectional associations between hypertension and psychosocial risk factors have been observed, although there is considerable heterogeneity between different studies, and an absence of associations has been observed as well [30][31][32]. Overall, the present findings do not confirm a strong effect of hypertension as part of a cardiac risk profile, on the association between PE and long-term psychosocial distress.…”

Section: Discussioncontrasting

confidence: 84%

Long-term follow-up of psychosocial distress after early onset preeclampsia: the Preeclampsia Risk EValuation in FEMales cohort study

Mommersteeg

Drost

Ottervanger

et al. 2016

Journal of Psychosomatic Obstetrics & Gynecology

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Objective: To examine long-term psychosocial distress in women with a history of early onset preeclampsia (PE) compared to a comparison group. Methods: Women with and without a history of early onset PE participating in the 'Preeclampsia Risk EValuation in FEMales' (PREVFEM) study were sent questionnaires, on average 14.1 years (SD ¼ 3.2, range 5-23 years) after the index pregnancy. In total 265 (77%) women with PE and 268 (78%) age-matched women without PE returned questionnaires (mean age 43.5, SD ¼4.6 years). Group differences were examined on indicators of psychosocial distress, depressive symptoms, anxiety, fatigue, loneliness, marital quality, trait optimism and Type D personality, and unadjusted and adjusted for a priori chosen and study-specific covariates. In secondary analyses, the effect of previously detected hypertension was examined, as well as pregnancy-related events within the PE group. Results: Women with a history of PE reported more subsequent depressive symptoms (B ¼ 0.70, 95% CI 0.09-1.32, p ¼ 0.026) and more fatigue (B ¼ 1.12, 95% CI 0.07-2.18, p ¼ 0.037) compared to the non-PE group, but the differences explained less than 1% of the variance. The differences remained after adjustment for age, BMI and education level, and additional adjustment for partner, being unemployed and physical activity. No significant differences were observed for anxiety, loneliness, marital quality, optimism, or Type D personality. These differences were not explained by fouryear previously measured elevated blood pressure in the PE group. Having had a stillborn child or early neonatal death during the index pregnancy was associated with higher depressive symptoms, anxiety, fatigue, and loneliness in the PE group, but these factors explained only a small proportion of the variance in these psychosocial distress factors. Conclusion: A history of early PE is associated with slightly higher levels of depressive symptoms and fatigue on average 14 years later, but this is unlikely to be of clinical relevance. ARTICLE HISTORY

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Section: Discussioncontrasting

confidence: 84%

Long-term follow-up of psychosocial distress after early onset preeclampsia: the Preeclampsia Risk EValuation in FEMales cohort study

Mommersteeg

Drost

Ottervanger

et al. 2016

Journal of Psychosomatic Obstetrics & Gynecology

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“…This finding may support the hypothesis that CVD and depression share common pathophysiological mechanisms [4][5][6] . As an alternative, depression and CVD may share risk factors but not the mechanisms through which these risk factors act.…”

supporting

confidence: 87%

“…Possessing both DISC1 and 5-HTTLPR risk genotypes resulted in a 1.7-fold increase in PTSD symptoms. Although this is the first report of DISC1 S704C TT allele as a risk factor for PTSD, the finding is not surprising, considering that this allele has been identified as a risk factor for major depression 4 . DISC1 variants interfere with a protein complex important for organelle transport and in tethering of mitochondria, interfering with dendritic development and reducing densities of dendritic spines in the frontal cortex, paralleling our recent report of spine density reductions in the frontal cortex in PTSD [5][6][7] .…”

mentioning

confidence: 60%

“…However, there is contradictory evidence that an association can also be observed between insulin resistance and depression among individuals without diabetes 2 . To address this inconsistency, three recent reviews [3][4][5] , including one published in this journal 5 , have called for greater precision in studies, proposing that specific depression profiles (e.g., atypical depression) should be further investigated. We conducted a population-level investigation on the importance of atypical and non-atypical depressive symptoms in specific pre-diabetic states as well as in previously undiagnosed and diagnosed diabetes mellitus.…”

Section: Depressive Symptom Profiles and Glucose Tolerance Statusmentioning

confidence: 99%

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Cardiovascular risk and incidence of depression in young and older adults: evidence from the SUN cohort study

et al. 2017

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two genetic variants continued to be significant factors in the ANCOVA analysis, which included age and education as covariates. The model also remained significant in a follow-up analysis in which participants who identified as AfricanAmerican (N515) were excluded.Carriers of the 5HTTLPR-S' allele had increased PTSD symptoms compared to individuals homozygous for the L' allele (IES mean score: L'L'547.3 6 5.3, S559.8 6 4.1). For DISC1, individuals homozygous for the T allele had increased PTSD symptoms compared to A carriers (A545.3 6 2.8, TT561.9 6 7.2). In ANCOVA analysis of symptom sub-factors, 5-HTTLPR and DISC1 selectively influenced intrusion and hypervigilance symptoms, but did not affect avoidance symptoms. PTSD symptom severity (total IES scores) increased by an average of 40% with each risk genotype (none538.4, one5 54.5, two565.6).These data support prior observations of 5-HTTLPR effects on PTSD symptoms in military veterans 1,2 . Although 5-HTTLPR has been identified as a potential contributor to PTSD susceptibility in civilian-based populations, its effect may be less robust in those populations, due to lower overall level of trauma exposure 3 . The effects of 5-HTTLPR on PTSD in military veterans after deployment to a war zone may be more robust because of a universal and constant exposure to threat, military training, and/or separation from family and home social support.In addition to 5-HTTLPR, genetic variation in DISC1, a gene associated with susceptibility to multiple mental disorders, was found to contribute to PTSD symptom severity. Possessing both DISC1 and 5-HTTLPR risk genotypes resulted in a 1.7-fold increase in PTSD symptoms. Although this is the first report of DISC1 S704C TT allele as a risk factor for PTSD, the finding is not surprising, considering that this allele has been identified as a risk factor for major depression 4 . DISC1 variants interfere with a protein complex important for organelle transport and in tethering of mitochondria, interfering with dendritic development and reducing densities of dendritic spines in the frontal cortex, paralleling our recent report of spine density reductions in the frontal cortex in PTSD 5-7 .This study was powered to screen for candidate genes with relatively large effect sizes on PTSD symptoms in combat veterans, which may be different from sets of genes affecting PTSD in civilian populations. Study of the serotonin system in PTSD is motivated in large part by the therapeutic utility of serotonin uptake inhibitors to treat symptoms of PTSD. Our data provide additional impetus for continued study of this system in PTSD pharmacotherapy. In addition, antipsychotics such as risperidone have been shown to reverse DISC1-related behavioral deficits and pathophysiology in animal models, suggesting the possibility that such agents could be re-examined for use as alternative pharmacotherapies for PTSD 8,9 .

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“…57 Depression is an independent risk factor for ischemic heart disease and cardiovascular mortality, 58,59 and vascular risk factors are also associated with onset of depression in later life. 60 The presence of depression substantially increases the level of disability 61 and reduces quality of life [62][63][64] in individuals with chronic medical illness.…”

Section: What Is the Impact Of Mdd On Physical Health?mentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

et al. 2016

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Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. This section is the first of six guidelines articles.Results: In Canada, the annual and lifetime prevalence of MDD was 4.7% and 11.3%, respectively. MDD represents the second leading cause of global disability, with high occupational and economic impact mainly attributable to indirect costs. DSM-5 criteria for depressive disorders remain relatively unchanged, but other clinical dimensions (sleep, cognition, physical symptoms) may have implications for depression management. e-Mental health is increasingly used to support clinical and selfmanagement of MDD. In the 2-phase (acute and maintenance) treatment model, specific goals address symptom remission, functional recovery, improved quality of life, and prevention of recurrence. Conclusions:The burden attributed to MDD remains high, whether from individual distress, functional and relationship impairment, reduced quality of life, or societal economic cost. Applying core principles of care, including comprehensive assessment, therapeutic alliance, support of self-management, evidence-informed treatment, and measurement-based care, will optimize clinical, quality of life, and functional outcomes in MDD.

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Vascular Risk Factors and Depression in Later Life: A Systematic Review and Meta-Analysis

Cited by 145 publications

References 91 publications

Long-term follow-up of psychosocial distress after early onset preeclampsia: the Preeclampsia Risk EValuation in FEMales cohort study

Long-term follow-up of psychosocial distress after early onset preeclampsia: the Preeclampsia Risk EValuation in FEMales cohort study

Cardiovascular risk and incidence of depression in young and older adults: evidence from the SUN cohort study

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

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