Journal of Psychosomatic Research最新文献

{"title":"Association between fluctuations in blood cholesterol levels and the risk of suicide death in the general population","authors":"Chaiho Jeong ,&nbsp;Jin-Hyung Jung ,&nbsp;Dae Jong Oh ,&nbsp;Kyungdo Han ,&nbsp;Mee Kyoung Kim","doi":"10.1016/j.jpsychores.2024.111956","DOIUrl":"10.1016/j.jpsychores.2024.111956","url":null,"abstract":"<div><h3>Objective</h3><div>Suicide is a pressing global public health issue. While recent studies have explored the association between serum cholesterol levels and suicide risk<strong>,</strong> the association between cholesterol variability and suicide risk is not well characterized.</div></div><div><h3>Methods</h3><div>This was a nationwide population-based cohort study using data from the Korean National Health Insurance Service database. A total of 1,983,701 patients with at least three measurements of TC between 2004 and 2009 were included. Participants were followed until death by suicide or the study's end in December 2021. Participants were categorized based on baseline TC or TC variability. TC variability was assessed using coefficient of variation (CV), variability independent of the mean (VIM), and average successive variability (ASV).</div></div><div><h3>Results</h3><div>Over a median follow-up of 11 years, 5883 (0.3 %) patients died by suicide. Compared to subjects with TC &lt;200 mg/dL, those with TC ≥240 mg/dL had a lower risk of suicide death (hazard ratio [HR]: 0.85, 95 % confidence interval [95 % CI]: 0.78–0.93). In the unadjusted model, the HR for suicide death in the highest quartile (Q4) compared to the lowest quartile (Q1) of TC variability was 1.36 (95 % CI: 1.26–1.46). After adjusting for potential confounders, high variability in TC levels was associated with a higher risk of suicide death (HR 1.27, 95 % CI: 1.18–1.37). When analyzed based on the combination of TC baseline and variability, the highest quartile of TC variability showed a higher rate of suicide death compared to the lowest quartile, regardless of baseline TC level.</div></div><div><h3>Conclusion</h3><div>High TC variability and low TC levels were associated with an increased risk of suicide.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"187 ","pages":"Article 111956"},"PeriodicalIF":3.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissecting the association between long COVID and depressive symptoms in a nationally representative population from France","authors":"Sarah Tebeka ,&nbsp;Joël Coste ,&nbsp;Tatjana T. Makovski ,&nbsp;Caroline Alleaume ,&nbsp;Cyrille Delpierre ,&nbsp;Anne Gallay ,&nbsp;Baptiste Pignon ,&nbsp;Clément Gouraud ,&nbsp;Charles Ouazana Vedrines ,&nbsp;Victor Pitron ,&nbsp;Olivier Robineau ,&nbsp;Olivier Steichen ,&nbsp;Cédric Lemogne","doi":"10.1016/j.jpsychores.2024.111961","DOIUrl":"10.1016/j.jpsychores.2024.111961","url":null,"abstract":"<div><h3>Objective</h3><div>Depressive symptoms may overlap with those of long COVID. This cross-sectional study aims to compare the prevalence of depressive symptoms among individuals infected with SARS-CoV-2 with versus without long COVID and to explore specific associations with each of the nine core symptoms of major depression.</div></div><div><h3>Methods</h3><div>Data regarding age, gender, SARS-CoV-2 infections, current symptoms, their date of onset, impact on daily functioning, and consideration of alternative diagnoses were collected through phone interviews between September and December 2022 in a nationally representative sample of adults aged ≥18. Data on chronic health conditions and depressive symptoms (PHQ-9) were collected online in infected participants with or without long COVID, according to the WHO definition of the post-COVID-19 condition.</div></div><div><h3>Results</h3><div>Among 1247 participants (mean age (SD): 48.3 (14.3) years, 53.3 % of women), 12.8 % had long COVID and 87.2 % experienced SARS-CoV-2 infection at least 3 months prior to the survey without long COVID. Participant with long COVID were four-fold more likely to have a PHQ-9 score ≥ 10 than those without (44.0 % versus 11.1 %). Three symptoms out of nine were independently associated with long COVID: little interest or pleasure (aOR [95 % CI]: 2.01 [1.03–3.92]), feeling tired or having little energy (1.92 [1.10–3.33]), and poor attention/concentration (2.02 [1.03–3.96]).</div></div><div><h3>Conclusion</h3><div>Clinicians should screen patients with long COVID for major depression but associations with specific depressive symptoms suggest some clinical overlap. Future studies should consider the course of each depressive symptom separately and focus on those less prone to overlap with symptoms of long COVID.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"187 ","pages":"Article 111961"},"PeriodicalIF":3.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-utility analysis of transdiagnostic cognitive behavioural therapy for people with persistent physical symptoms in contact with specialist services evaluated in the PRINCE secondary trial","authors":"Paul McCrone ,&nbsp;Meenal Patel ,&nbsp;Matthew Hotopf ,&nbsp;Rona Moss-Morris ,&nbsp;Mark Ashworth ,&nbsp;Anthony S. David ,&nbsp;Mujtaba Husain ,&nbsp;Kirsty James ,&nbsp;Sabine Landau ,&nbsp;Trudie Chalder","doi":"10.1016/j.jpsychores.2024.111960","DOIUrl":"10.1016/j.jpsychores.2024.111960","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the cost-utility of transdiagnostic cognitive behavioural therapy (TDT-CBT) plus standardised medical care (SMC) to SMC alone to support people with persistent physical symptoms in contact with specialist services.</div></div><div><h3>Methods</h3><div>This study compared the cost-utility of TDT-CBT. A two-arm randomised controlled trial was conducted in secondary care settings. Participants received either TDT-CBT + SMC or SMC alone. Measures were taken at baseline and at 9-, 20-, 40-, and 52-week follow-up. Service use was measured, and costs calculated. Costs were combined with quality-adjusted life years (QALYs) based on the EQ-5D-5L using incremental cost-utility ratios with uncertainty addressed using cost-effectiveness planes and acceptability curves.</div></div><div><h3>Results</h3><div>The costs during the follow-up period were £3473 for TDT-CBT + SMC and £3104 for SMC alone. The incremental cost for TDT-CBT + SMC adjusting for baseline was £482 (95 % CI, −£399 to £1233). QALYs over the follow-up were 0.578 for TDT-CBT + SMC and 0.542 for SMC alone. The incremental QALY was 0.038 (95 % CI, −0.005 to 0.080). The incremental cost per QALY was £12,684 for TDT-CBT + SMC. There was a 68.3 % likelihood that TDT-CBT + SMC was the most cost-effective option at a threshold of £20,000 per QALY.</div></div><div><h3>Conclusion</h3><div>Adding TDT-CTB to SMC results in slightly increased costs and slightly better outcomes in terms of QALYs. This represents a cost-effective option based on the conventional QALY threshold value.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"187 ","pages":"Article 111960"},"PeriodicalIF":3.5,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persian version of the Short Health Anxiety Inventory (SHAI) for patients with cancer: Evaluation of psychometric properties, factor structure, and association with related constructs","authors":"M. Mojtaba Poshtan ,&nbsp;Abdulaziz Aflakseir ,&nbsp;Michael Witthöft ,&nbsp;Mary Gemma Cherry ,&nbsp;Mani Ramzi","doi":"10.1016/j.jpsychores.2024.111958","DOIUrl":"10.1016/j.jpsychores.2024.111958","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate the psychometric properties of the Short Health Anxiety Inventory (SHAI=short health anxiety inventory) in a sample of patients diagnosed with cancer. Factor structure, internal consistency, convergent validity, and gender differences in SHAI scores were assessed.</div></div><div><h3>Methods</h3><div>202 patients diagnosed with cancer participated, with 18 questionnaires excluded for incomplete data. Confirmatory Factor Analysis was conducted to confirm the factor structure. Internal consistency was also assessed using Cronbach's alpha.</div></div><div><h3>Results</h3><div>A two-factor model (thought intrusion and fear of illness) provided the best fit for the data (SBχ² (64) = 114.346, <em>p</em> &lt; 0.001, CFI = 0.944, GFI = 0.908, RMSEA = 0.065). Internal consistency was high for the SHAI total score (α = 0.864) and its subscales (thought intrusion: α = 0.753; fear of illness: α = 0.825). Female patients also scored significantly higher than male patients on the SHAI total score (U = 5232.500, <em>p</em> = 0.012), thought intrusion subscale (U = 5189.00, <em>p</em> = 0.008) and fear of illness subscale (U = 5069.500, <em>p</em> = 0.018).</div></div><div><h3>Conclusion</h3><div>The SHAI demonstrates adequate psychometric properties for assessing health anxiety in cancer patients.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"187 ","pages":"Article 111958"},"PeriodicalIF":3.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The psychosocial anti-inflammatories: Sense of control, purpose in life, and social support in relation to inflammation, functional health and chronic conditions in adulthood","authors":"Margie E. Lachman,&nbsp;Kylie A. Schiloski","doi":"10.1016/j.jpsychores.2024.111957","DOIUrl":"10.1016/j.jpsychores.2024.111957","url":null,"abstract":"<div><h3>Objective</h3><div>Three psychosocial variables were examined as predictors of chronic inflammation, functional health, and number of chronic conditions.</div></div><div><h3>Methods</h3><div>This cohort study used the Midlife in the United States biomarker sample. Data were collected in 2004–2009 (M2) and 2013–17 (M3). The sample included 1244 adults ages 34 to 82 (M = 54.50, SD = 11.7), with 57 % women, 79 % white, and education from 6 to 20 years (M = 14.47, SD = 2.65). Sense of control, purpose in life, and social support were included as indicators of a psychosocial latent factor. Inflammation was measured with Interleukin-6, C-reactive Protein, E-Selectin, Fibrinogen, and Intracellular Adhesion Molecule-1. Covariates included age, sex, education, race, and household income. Functional health and chronic conditions were assessed M = 9.27 (SD = 0.78) years after the psychosocial variables and M = 7.06, (SD = 1.47) years after inflammation.</div></div><div><h3>Results</h3><div>Using a structural equation model and controlling for covariates, higher levels on the psychosocial variables predicted lower inflammation (β = −0.12, 95 % CI -0.22 to −0.02; <em>p</em> = .016), better functional health (β = 0.25, 95 % CI 0.18 to 0.32; <em>p</em> &lt; .001), and fewer chronic conditions (β = −0.22, 95 % CI −0.30 to −0.15; <em>p</em> &lt; .001), with inflammation a mediator (indirect effects: functional health, β = 0.03, 95 % CI 0.00 to 0.05, <em>p</em> = .020 and chronic conditions, β = −0.02, 95 % CI -0.03 to −0.00, <em>p</em> = .036).</div></div><div><h3>Conclusions</h3><div>Adaptive psychosocial beliefs and supportive relationships are important as they can provide motivation for engaging in health-promoting behaviors and can reduce stress that can lead to chronic inflammation and poor health. The results can inform a psychosocial prescription for health.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"187 ","pages":"Article 111957"},"PeriodicalIF":3.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting uncertainty through trajectory analysis of noncardiac chest pain","authors":"Trygve Dolber","doi":"10.1016/j.jpsychores.2024.111955","DOIUrl":"10.1016/j.jpsychores.2024.111955","url":null,"abstract":"","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"187 ","pages":"Article 111955"},"PeriodicalIF":3.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term treatment outcomes of mindfulness-based cognitive therapy for fatigue in patients with inflammatory bowel disease: Results of a randomized controlled trial","authors":"Quirine M. Bredero ,&nbsp;Joke Fleer ,&nbsp;Ans Smink ,&nbsp;Greetje Kuiken ,&nbsp;Joke Potjewijd ,&nbsp;Marleen Laroy ,&nbsp;Marijn C. Visschedijk ,&nbsp;Maurice Russel ,&nbsp;Mark van der Lugt ,&nbsp;Maarten A.C. Meijssen ,&nbsp;Egbert Jan van der Wouden ,&nbsp;Gerard Dijkstra ,&nbsp;Maya J. Schroevers","doi":"10.1016/j.jpsychores.2024.111949","DOIUrl":"10.1016/j.jpsychores.2024.111949","url":null,"abstract":"<div><h3>Objectives</h3><div>Fatigue is prevalent in patients with inflammatory bowel disease (IBD) in remission. Previously, we showed that fatigued IBD patients experienced a significant decrease in fatigue after receiving mindfulness-based cognitive therapy (MBCT). The current study examined to what extent these short-term beneficial effects of MBCT on fatigue were maintained over nine months follow-up, and whether patient characteristics were associated with clinically relevant improvement in fatigue.</div></div><div><h3>Methods</h3><div>A randomized controlled trial, including an MBCT and waiting-list control condition, was performed in fatigued IBD patients in remission. For this study, we analysed long-term outcomes of 108 patients who received MBCT (either directly or after three months waiting). The primary outcome was fatigue, assessed with the Checklist Individual Strenght-20. Secondary outcomes included fatigue interference, depression, anxiety, and quality of life.</div></div><div><h3>Results</h3><div>The reduced level of fatigue post-treatment did not change significantly during follow-up (F(2,76) = 1.68, <em>p</em> = 0.19). In total, 29% of patients reported clinically relevant improvement from pre-treatment to nine months follow-up. We found few significant differences in baseline characteristics between those reporting clinically relevant improvement and those not, except that patients who improved were significantly more often unemployed (<em>χ</em>²(1, <em>n</em> = 73) = 4.40, <em>p</em> = 0.04). Secondary outcomes, which did not change significantly during MBCT, also remained stable during follow-up.</div></div><div><h3>Conclusion</h3><div>Findings suggest that reductions in IBD-related fatigue after receiving MBCT are sustained over nine months follow-up, with around one-third of patients reporting clinically relevant improvement from pre-treatment to follow-up. Employment status might be related to improvements in fatigue. Future research is needed to confirm these long-term outcomes.</div></div><div><h3>Preregistration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> ID: <span><span>NCT03162575</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"187 ","pages":"Article 111949"},"PeriodicalIF":3.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of treatment response trajectories to cognitive behavioral therapy for chronic fatigue syndrome: A cohort study","authors":"Lukas Van Oudenhove ,&nbsp;Soetkin Debyser ,&nbsp;Elfi Vergaelen ,&nbsp;Stephan Claes ,&nbsp;Maaike Van Den Houte","doi":"10.1016/j.jpsychores.2024.111954","DOIUrl":"10.1016/j.jpsychores.2024.111954","url":null,"abstract":"<div><h3>Background</h3><div>The response to cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) varies greatly between patients, but predictors of treatment success remain to be elucidated. We aimed to identify patient subgroups based on fatigue trajectory during CBT, identify pre-treatment predictors of subgroup membership, and disentangle the direction of predictor – outcome relationships over time.</div></div><div><h3>Methods</h3><div>297 individuals with CFS were enrolled in a standardized CBT program consisting of 17 sessions, with session timing variable between participants. Self-reported levels of fatigue, depressive, anxiety, and somatic symptoms, perceived stress, and positive affect were collected pre-treatment, and after 3, 10, and 15 sessions. Latent Class Growth Analysis (LCGA) was used to identify subgroups based on fatigue trajectories and baseline predictors of group membership. Cross-lagged structural equation models were used to disentangle predictor-outcome relationships.</div></div><div><h3>Results</h3><div>LCGA identified four fatigue trajectory subgroups, which were labelled as “no improvement” (23 %), “weak improvement” (45 %), “moderate improvement” (23 %), and “strong improvement” (9 %) classes. Higher pre-treatment levels of depressive, anxiety, and somatic symptoms, stress, and lower levels of positive affect predicted membership of the “no improvement” subgroup. Reductions in anxiety preceded reductions in fatigue, while the depressive symptoms – fatigue relationship was bidirectional.</div></div><div><h3>Conclusions</h3><div>On a group level, there were statistically significant reductions in fatigue after 15 sessions of CBT, with important individual differences in treatment response. Higher pre-treatment levels of anxious, depressive, and somatic symptoms and perceived stress are predictors of lack of response, with reductions in anxiety and stress preceding improvements in fatigue.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"187 ","pages":"Article 111954"},"PeriodicalIF":3.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can the Whiteley Index be used to assess health anxiety in adolescents from the general population?","authors":"Charlotte Steen Duholm ,&nbsp;Davíð R.M.A. Højgaard ,&nbsp;Eva Ørnbøl ,&nbsp;Kaare Bro Wellnitz ,&nbsp;Per Hove Thomsen ,&nbsp;Martin Køster Rimvall ,&nbsp;Charlotte Ulrikka Rask","doi":"10.1016/j.jpsychores.2024.111946","DOIUrl":"10.1016/j.jpsychores.2024.111946","url":null,"abstract":"<div><div>Health anxiety (HA) is characterized by worry about being or becoming ill. The Whiteley Index (WI) is a valid and frequently used measure for HA in adults. We examined item response distribution, floor and ceiling effects, and construct validity of four different one-factor models of the WI (an 8-item model, the widely used WI-7, a revised 7-item version (WI-7-R), and a 6-item version (WI-6-R)) in a population-based sample of adolescents, using data from the 16–17-year follow-up of the Copenhagen Child Cohort 2000 (<em>N</em> = 2521, 16–17 years old). Females generally scored higher on all eight WI items compared to males. Construct validity was examined by confirmatory factor analysis and hypothesis testing. The WI-7-R and WI-6-R both showed acceptable fits. All four models showed good internal consistency. Hypothesis testing showed good discriminant validity, as the hypotheses on positive correlations with anxiety, depression, and physical symptoms, as well as a negative correlation with health-related quality of life, were met for both the WI-7-R and WI-6-R. We advocate for the use of the WI-6-R, which focuses on core HA symptoms and excludes items concerning physical symptoms. The overall testing supports that the WI-6-R possesses valid psychometric properties for use with adolescents in the general population.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"187 ","pages":"Article 111946"},"PeriodicalIF":3.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major depressive disorder, neuroticism, suicidal behaviors, and depression severity are associated with cytokine networks and their intricate interactions with metabolic syndrome","authors":"Michael Maes ,&nbsp;Ketsupar Jirakran ,&nbsp;Asara Vasupanrajit ,&nbsp;Bo Zhou ,&nbsp;Chavit Tunvirachaisakul ,&nbsp;Abbas F. Almulla","doi":"10.1016/j.jpsychores.2024.111951","DOIUrl":"10.1016/j.jpsychores.2024.111951","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify alterations in the immune profiles in outpatients with major depression (MDD), and its associations with key features, such as suicidal ideation, neuroticism, cognitive symptoms, and the depression phenome while accounting for metabolic syndrome (MetS).</div></div><div><h3>Methods</h3><div>In this case-control study, we assayed 48 serum cytokines, chemokines, and growth factors in 67 healthy controls and 66 MDD outpatients. Around 50 % of the outpatient MDD and control participants had a diagnosis of MetS.</div></div><div><h3>Results</h3><div>Ten differentially expressed proteins (DEPs) were upregulated in outpatient MDD (i.e., CXCL12, tumor necrosis factor [TNF]β, platelet-derived growth factor [PDGF], CCL11, interleukins [IL]9, IL4, CCL5, CCL2, CCL4, IL1 receptor antagonist [IL1RN]), indicating an immune and defense response. Six DEPs were downregulated (vascular endothelial growth factor A [VEGFA], IL12, CCL3, colony stimulating factor [CSF]1, IL1B, nerve growth factor [NGF]), indicating lowered neurogenesis and neuron death regulation. Significant interactions between outpatient MDD and MetS caused a) substantial increases in IL4, IL17, TNF, TNFB, CCL2, CCL5, PDGF, IL1RN; and b) downregulation of VEGFA and FGF. A large part of the variance in neuroticism (26 %), suicidal behaviors (23 %), and the MDD phenome (31 %) was predicted by immunological data and interactions between MetS and CCL5, TNFB or VEGFA.</div></div><div><h3>Conclusion</h3><div>Outpatient MDD is characterized by a cytokine profile with neurotoxic potential which partly explains neuroticism, suicidal behaviors, and the phenome's severity. Lowered IL-10 and activated cytokine profiles with neurotoxic potential are characteristics of outpatient MDD and other depression phenotypes, including severe first-episode inpatient MDD. The presence of MetS in outpatient MDD considerably activates immune profiles with neurotoxic potential. Consequently, immune studies in MDD should always be performed in subjects with and without MetS.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"187 ","pages":"Article 111951"},"PeriodicalIF":3.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}