Genome-Wide Association Analysis Accounting for Environmental Factors Through Propensity-Score Matching: Application to Stressful Live Events in Major Depressive Disorder.
Genome-wide association analysis accounting for environmental factors through propensity-score matching: Application to stressful live events in major depressive disorder.
Am J Med Genet B Neuropsychiatr Genet. 2013 Jul 15;
Power RA, Cohen-Woods S, Ng MY, Butler AW, Craddock N, Korszun A, Jones L, Jones I, Gill M, Rice JP, Maier W, Zobel A, Mors O, Placentino A, Rietschel M, Aitchison KJ, Tozzi F, Muglia P, Breen G, Farmer AE, McGuffin P, Lewis CM, Uher R
Stressful life events are an established trigger for depression and may contribute to the heterogeneity within genome-wide association analyses. With depression cases showing an excess of exposure to stressful events compared to controls, there is difficulty in distinguishing between “true” cases and a “normal” response to a stressful environment. This potential contamination of cases, and that from genetically at risk controls that have not yet experienced environmental triggers for onset, may reduce the power of studies to detect causal variants. In the RADIANT sample of 3,690 European individuals, we used propensity score matching to pair cases and controls on exposure to stressful life events. In 805 case-control pairs matched on stressful life event, we tested the influence of 457,670 common genetic variants on the propensity to depression under comparable level of adversity with a sign test. While this analysis produced no significant findings after genome-wide correction for multiple testing, we outline a novel methodology and perspective for providing environmental context in genetic studies. We recommend contextualizing depression by incorporating environmental exposure into genome-wide analyses as a complementary approach to testing gene-environment interactions. Possible explanations for negative findings include a lack of statistical power due to small sample size and conditional effects, resulting from the low rate of adequate matching. Our findings underscore the importance of collecting information on environmental risk factors in studies of depression and other complex phenotypes, so that sufficient sample sizes are available to investigate their effect in genome-wide association analysis. © 2013 Wiley Periodicals, Inc. HubMed – depression
Korean medication algorithm for bipolar disorder: Second revision.
Asia Pac Psychiatry. 2013 Apr 2;
Shin YC, Min KJ, Yoon BH, Kim W, Jon DI, Seo JS, Woo YS, Lee JG, Bahk WM
The Feasibility Study of the Korean Medication Algorithm Project for Bipolar Disorder 2002 (KMAP-BP 2002) revealed its clinical usefulness in 2005. Since much more data had become available since 2002, it was revised in 2006 as KMAP-BP 2006. For the same reason, revision of KMAP-BP 2006 is now necessary.The questionnaire, amended on the basis of KMAP-BP 2006 and new data, was sent to 94 experts, 65 of whom replied.In an acute manic episode, a combination of a mood stabilizer (MS) with an atypical antipsychotic (AAP) is recommended as first-line strategy. Monotherapy with MS is first-line in a hypomanic episode. Triple combination of a MS, an AAP, and an antidepressant (AD), is the first-line strategy in non-psychotic severe depression. Also MS+AAP and MS+AD are recommended as first-line. In psychotic bipolar depression, MS+AAP+AD, MS+AAP and AAP+AD are first-line strategies. In bipolar depression, lithium, lamotrigine and valproic acid are selected as first-line MS and quetiapine, olanzapine and aripiprazole are preferred antipsychotics. In maintenance treatment, a combination of MS with AAP and monotherapy of MS are recommended as first-line.In treating bipolar disorder, even the first step of treatment, the expert consensus has changed from our studies in 2002 and 2006. HubMed – depression
Real-world, open-label study to evaluate the effectiveness of mirtazapine on sleep quality in outpatients with major depressive disorder.
Asia Pac Psychiatry. 2013 Feb 25;
Wang D, Li Z, Li L, Hao W
The objective of this study was to evaluate the effect of mirtazapine on sleep quality in real-world outpatients with major depressive disorder (MDD).Demographic characteristics of MDD outpatients were collected and the Pittsburgh Sleep Quality Index (PSQI) was assessed before and after treatment.In 3,924 MDD outpatients after treatment, sleep efficiency was significantly higher (P?0.001), global PSQI score was significantly lower (P?0.01), the reduction rates of sleep latency (P?0.01) and global PSQI score (P?0.001) were notably higher, and the proportion of using sleep medications (P?0.05) was significantly lower in the mirtazapine group. In 3,455 MDD outpatients with insomnia after treatment, the reduction of sleep latency (P?0.001), the prolongation of sleep duration (P?0.001), and the increase in habitual sleep efficiency (P?0.001) were more obvious, the reduction rates of sleep latency (P?0.05) and global PSQI score (P?0.001) were significantly higher, and the proportion of using sleep medications (P?0.001) was significantly lower in the mirtazapine group. In 469 MDD outpatients without insomnia after treatment, the reduction of sleep latency (P?0.05), the increase in sleep duration (P?0.001) and habitual sleep efficiency (P?0.001), and the reduction rate of global PSQI score (P?0.05) were significantly greater in the mirtazapine group.This real-world study suggests that mirtazapine improves sleep quality of MDD outpatients, and decreases the concomitant use of sleep medications. HubMed – depression
Quality of life of patients with epilepsy in Malaysia.
Asia Pac Psychiatry. 2012 Apr 18;
Mohamed S, Gill JS, Tan CT
To determine the quality of life of patients with epilepsy and its relationship with depression, and the clinical and sociodemographic variables.This was a cross-sectional study in which a total of 120 epilepsy patients were recruited from a neurology outpatient clinic. Sociodemographic and clinical variables were recorded. Hospital Anxiety and Depression Scale (HADS) and Mini International Neuropsychiatric Interview (M.I.N.I.) were used to screen and diagnose for depression, respectively. Quality of Life Inventory of Epilepsy (QOLIE-31) was used to assess quality of life.Patients with epilepsy with major depression had poorer quality life (36.4?±?1.8) compared to those without depression (41.7?±?3.8, P?0.001). Depression, having one seizure or more per month and having seizures within one month of interview were correlated with poorer quality of life, P?0.001. Multivariate linear regression analyses showed that depression and recent seizures predicted having poorer quality of life in patients with epilepsy.Depression and poor seizure control were predictors for poor quality of life in patients with epilepsy. Therefore, epilepsy patients should be regularly screened for depression and treatment for epilepsy must be optimized to minimize the negative impact of having epilepsy for these patients. HubMed – depression
Health-related quality of life and symptom severity in Chinese patients with major depressive disorder.
Asia Pac Psychiatry. 2013 Feb 21;
Cao Y, Li W, Shen J, Malison RT, Zhang Y, Luo X
Patients suffering from major depressive disorder (MDD) have been reported to have substantial long-lasting limitations in multiple domains of health-related quality of life (HRQoL). The thoughtful assessment of HRQoL and the impact of treatment response on HRQoL are emerging as important issues in the care of patients with major depressive disorder.One hundred and three patients meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for MDD took fluoxetine (20?mg/d) for 6 weeks and were assessed by the Short Form 36 Health Survey (SF-36), the 17-item Hamilton Depression Rating (HAMD-17) and the Clinical Global Impression (CGI) scales. Relationships between SF-36 scores and depressive symptom severity and early change of these symptoms were tested.SF-36 component scores at week 6 were higher than those at baseline (all P???0.0058). Scores for general health were significantly higher in responders than non-responders (P?=?0.0009). The overall HAMD-17 and CGI scores at 2- and 6-week follow-up were significantly lower than those at baseline (P???0.0001). Higher scores for anxiety/somatization were significantly associated with poorer SF-36 scores at baseline (P?=?0.0001); role-physical scores at week 6 were positively correlated with reduction rate of anxiety/somatization in 2-week follow-up (P?=?0.0002).Depressive symptom severity was associated with HRQoL in patients with MDD. HRQoL may vary with severity of depression and/or anxiety-somatization at baseline. HubMed – depression