Journal of Clinical Medicine

Editorial

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5 pages, 568 KiB

Open AccessEditorial

Unresolved Systemic Inflammation, Long COVID, and the Common Pathomechanisms of Somatic and Psychiatric Comorbidity

by Chih-Sung Liang, Piotr Gałecki and Kuan-Pin Su

J. Clin. Med. 2022, 11(17), 5114; https://doi.org/10.3390/jcm11175114 - 30 Aug 2022

Cited by 10 | Viewed by 1724

Abstract

Monoamine hypothesis is an overestimated hypothesis of major depressive disorder (MDD), and the treatments and biomarkers that target it only show modest effect in randomized controlled trials+ (RCTs) or case–control studies [...] Full article

(This article belongs to the Special Issue Depressive Disorders—Common Pathomechanisms of Somatic and Psychiatric Comorbidity)

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Research

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8 pages, 648 KiB

Open AccessArticle

Comparison of the Differences in State-Trait Anxiety Inventory Scores and Insomnia Histories between Monozygotic and Dizygotic Twins: A Cross-Sectional Study Using KoGES HTS Data

by So Young Kim, Dae Myoung Yoo, Mi Jung Kwon, Ji Hee Kim, Joo-Hee Kim, Woo Jin Bang and Hyo Geun Choi

J. Clin. Med. 2022, 11(14), 4011; https://doi.org/10.3390/jcm11144011 - 11 Jul 2022

Cited by 3 | Viewed by 1774

Abstract

The heritability of anxiety and its association with insomnia have been suggested. This study investigated the coincidence of anxiety and insomnia in monozygotic twins compared to dizygotic twins. The Korean Genome and Epidemiology Study 2005–2014 was used. The ≥20-year-old cohort population was composed [...] Read more.

The heritability of anxiety and its association with insomnia have been suggested. This study investigated the coincidence of anxiety and insomnia in monozygotic twins compared to dizygotic twins. The Korean Genome and Epidemiology Study 2005–2014 was used. The ≥20-year-old cohort population was composed of 1300 twin participants. A total of 980 monozygotic twins and 232 dizygotic twins were compared for the concordance for the history of insomnia in both twin pairs (coincidence of insomnia) and the difference in state of anxiety and trait of anxiety scores. The odds ratios (ORs) for the coincidence of insomnia in monozygotic twins compared to dizygotic twins were analyzed using multiple logistic regression analysis. The estimated values (EV) of the difference of state and trait of anxiety scores were analyzed using a linear regression model. The coincidence of insomnia was not high in monozygotic twins compared to dizygotic twins. The difference in the state of anxiety score was comparable between monozygotic twins and dizygotic twins. However, the difference in anxiety scores was higher in dizygotic twins than in monozygotic twins. The monozygotic twin group did not demonstrate higher coincidence of insomnia or the state of anxiety than the dizygotic twin group. However, the monozygotic twin group indicated higher coincidence of the trait of anxiety than the dizygotic twins. The current results implied the potential contribution of heritable factors for the trait of anxiety. Full article

(This article belongs to the Special Issue Depressive Disorders—Common Pathomechanisms of Somatic and Psychiatric Comorbidity)

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13 pages, 1709 KiB

Open AccessArticle

Risk of Depression during Menopause in Women from Poland, Belarus, Belgium, and Greece

by Katarzyna Krajewska-Ferishah, Agnieszka Kułak-Bejda, Agnieszka Szyszko-Perłowska, Andrei Shpakou, Katarzyna Van Damme-Ostapowicz and Antigoni Chatzopulu

J. Clin. Med. 2022, 11(12), 3371; https://doi.org/10.3390/jcm11123371 - 12 Jun 2022

Cited by 4 | Viewed by 2509

Abstract

Introduction: Menopause is a physiological period in a woman’s life, but it is often accompanied by symptoms that affect mental well-being and general health, including a tendency for depression. Aim of the study: To evaluate the predisposition to the symptoms of depression in [...] Read more.

Introduction: Menopause is a physiological period in a woman’s life, but it is often accompanied by symptoms that affect mental well-being and general health, including a tendency for depression. Aim of the study: To evaluate the predisposition to the symptoms of depression in women from Poland, Belarus, Belgium, and Greece. Material and methods: the method of diagnostic survey was used, and the research tools were: The Menopause Rating Scale, the Kupperman Index, Beck Depression Inventory, and a self-made survey questionnaire. Results: Hormone replacement therapy (HRT) was used by 15.8% of Polish, 19% of Belgian, 14.3% of Belarusian, and 15.2% of Greek women patients. The mean value of the Kupperman Index (range 0–63) in Poland was 14.8 ± 8.6, in Belgium—15.5 ± 6.6, Belarus—14.0 ± 9.4, and Greece—10.8 ± 6.5, while the total measure of Menopause Rating Scale (MRS) (range 0–44) was 12.2 ± 7.6 in Poland, 13.8 ± 6.5 in Belgium, 10.8 ± 8.0 in Belarus and 12.9 ± 7.4 in Greece. The severity of mental distress followed a similar pattern across all countries (slightly stronger than mild). The results for somatic complaints were similar, whereas the level of sexual issues varied, with the highest in Belgium and the lowest in Belarus. The mildest symptoms of menopause were experienced by Belarusian women and the most severe by Belgian women. The severity of depression, according to the Beck Depression Inventory (range 0–63), was as follows: Poland 10.5 ± 7.9; Belgium—11.1 ± 5.7; Belarus—13.7 ± 5.7; Greece—11.8 ± 6.6. Conclusions: The differences between the development of perimenopausal-related symptoms across countries were statistically significant. The incidence and severity of depression showed statistically significant differences between the countries studied—the highest was in Belarus and the lowest in Poland. Depression levels were not differentiated by subjects’ age or the use of hormone therapy but by subjects’ education. In Poland and Belarus, increased menopausal pain measured by the Kupperman Index altered levels of depression; in Belgium, there were no such correlations, and in Greece, the correlation was statistically significant, but its strength was negligible. A clearer correlation of the effects of development in menopausal symptoms on the level of depression was shown when measured with the MRS scale—in Greece and Belgium, the correlation was relatively weak, but in Poland and Belarus, it was relatively high. Full article

(This article belongs to the Special Issue Depressive Disorders—Common Pathomechanisms of Somatic and Psychiatric Comorbidity)

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15 pages, 757 KiB

Open AccessArticle

Pathways Linking the Big Five to Psychological Distress: Exploring the Mediating Roles of Stress Mindset and Coping Flexibility

by Luxi Chen, Li Qu and Ryan Y. Hong

J. Clin. Med. 2022, 11(9), 2272; https://doi.org/10.3390/jcm11092272 - 19 Apr 2022

Cited by 14 | Viewed by 5347

Abstract

Personality affects the vulnerability to the emotional symptoms of depression and anxiety. This study investigated whether stress mindset (general belief about the nature of stress) and coping flexibility (the ability to terminate ineffective coping strategies and adopt alternative ones) mediate the relations of [...] Read more.

Personality affects the vulnerability to the emotional symptoms of depression and anxiety. This study investigated whether stress mindset (general belief about the nature of stress) and coping flexibility (the ability to terminate ineffective coping strategies and adopt alternative ones) mediate the relations of the Big Five personality traits to psychological distress. A total of 260 undergraduate students (60.4% female) in Singapore completed self-reported questionnaires. A series of path analyses was performed. Firstly, a dual-pathway model of stress coping was established, which consisted of (a) a stress–threat–distress pathway where a stress-is-a-threat mindset mediated the association between stressful experiences and psychological distress and (b) a challenge–flexibility–enhancement pathway where coping flexibility mediated the relation of a stress-is-a-challenge mindset to a lower level of psychological distress, without being influenced by stressful experiences. Furthermore, Neuroticism was associated with the stress–threat–distress pathway, with stressful experiences and a stress-is-a-treat mindset mediating the relation of Neuroticism to psychological distress. Conscientiousness was associated with the challenge–flexibility–enhancement pathway, with a stress-is-a-challenge mindset and coping flexibility mediating the relation of Conscientiousness to less psychological distress. Extraversion, Agreeableness, and Openness were directly associated with greater coping flexibility. The findings enrich the literature on personality and stress coping and inform future interventions to promote mental health. Full article

(This article belongs to the Special Issue Depressive Disorders—Common Pathomechanisms of Somatic and Psychiatric Comorbidity)

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9 pages, 508 KiB

Open AccessArticle

An Elevated FIB-4 Score Is Associated with an Increased Incidence of Depression among Outpatients in Germany

by David Schöler, Karel Kostev, Münevver Demir, Mark Luedde, Marcel Konrad, Tom Luedde, Christoph Roderburg and Sven H. Loosen

J. Clin. Med. 2022, 11(8), 2214; https://doi.org/10.3390/jcm11082214 - 15 Apr 2022

Cited by 4 | Viewed by 1952

Abstract

Background: Liver disease and depression are known to be closely associated. Non-invasive tests (NIT), such as the FIB-4 score, have been recommended by different guidelines to rule out advanced fibrosis and to stratify the risk of liver-related outcomes in patients with chronic liver [...] Read more.

Background: Liver disease and depression are known to be closely associated. Non-invasive tests (NIT), such as the FIB-4 score, have been recommended by different guidelines to rule out advanced fibrosis and to stratify the risk of liver-related outcomes in patients with chronic liver diseases. However, the predictive value of an elevated FIB-4 score regarding the development of depression and/or anxiety disorders among the general population is unknown. Methods: By using the Disease Analyzer database (IQVIA), which compiles diagnoses and laboratory values as well as basic medical and demographic data of patients followed in general practices in Germany, we identified 370,756 patients with available lab values for FIB-4 score calculation between 2005 and 2019. Patients with an FIB-4 score < 2 were matched 1:1 to patients with an FIB-4 index ≥ 2 by age, sex and yearly consultation frequency. Results: In regression analysis, the incidence rate ratio (IRR) of depression was significantly higher among patients with an FIB-4 score ≥ 2.0 compared to patients with a lower FIB-4 score <2.0 (IRR: 1.12, p < 0.001). This association was significant for both female (IRR: 1.10, p = 0.004) and male (IRR: 1.15, p < 0.001) patients and strongest in the age groups ≤50 years (IRR: 1.42, p < 0.001) and 51-60 years (IRR: 1.34, p < 0.001). There was no significant association between an elevated FIB-4 score ≥ 2.0 and the incidence of depression among patients aged 60 years and older. There was no significant increase in the IRR of anxiety disorders for patients with high or low FIB-4 scores. Conclusion: Our study suggests a previously unknown association between an elevated FIB-4 score and an increased incidence of depression. This finding suggests that the FIB-4 score is not only a valuable tool for the prediction of liver-specific endpoints but also may be of relevance for the prediction of extrahepatic comorbidities, which in turn may argue for clinical screening programs in patients with an elevated FIB-4. Full article

(This article belongs to the Special Issue Depressive Disorders—Common Pathomechanisms of Somatic and Psychiatric Comorbidity)

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9 pages, 262 KiB

Open AccessArticle

The Relationships between Abnormal Serum Lipid Levels, Depression, and Suicidal Ideation According to Sex

by Kounseok Lee, Sunhae Kim and Jung Ki Jo

J. Clin. Med. 2022, 11(8), 2119; https://doi.org/10.3390/jcm11082119 - 11 Apr 2022

Cited by 10 | Viewed by 2751

Abstract

(1) Background: Serum lipid levels affect not only nutritional status but also emotional state. The purpose of this study was to examine the effects of various socio-demographic characteristics, abnormal cholesterol levels, and BMI indicators on depressive symptoms and suicidal ideation in the Korean [...] Read more.

(1) Background: Serum lipid levels affect not only nutritional status but also emotional state. The purpose of this study was to examine the effects of various socio-demographic characteristics, abnormal cholesterol levels, and BMI indicators on depressive symptoms and suicidal ideation in the Korean population. (2) Methods: A total of 23,692 people were surveyed using data from the Korea National Health and Nutrition Examination Survey (KNHNES) 2014, 2016, and 2018. Data from 11,653 patients were analyzed. Age, sex, chronic disease, smoking, alcohol consumption, total cholesterol (HDL, triglycerides), BMI, depression, and suicidal ideation were measured. (3) Results: According to sex, low HDL, high triglycerides, and suicidal ideation were significant, along with low education level, smoking, binge drinking, and high BMI. High triglyceride level was shown to significantly increase the risk of depression in males (OR = 1.535, 95% CI = 1.098–2.147). Factors affecting suicidal ideation in males were age, binge drinking, and depression, while blood lipid factors were not significant. (4) Conclusions: Of the types of serum lipid factors affecting depression and suicidal ideation, high triglycerides were found to be a risk factor for depression in men. Serum lipids can be used as biomarkers to reflect depressive symptoms in men depending on cholesterol level. Full article

(This article belongs to the Special Issue Depressive Disorders—Common Pathomechanisms of Somatic and Psychiatric Comorbidity)

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10 pages, 275 KiB

Open AccessArticle

Coping with Stress, Executive Functions, and Depressive Symptoms: Focusing on Flexible Responses to Stress

by Tsukasa Kato

J. Clin. Med. 2021, 10(14), 3122; https://doi.org/10.3390/jcm10143122 - 15 Jul 2021

Cited by 12 | Viewed by 2863

Abstract

Coping flexibility is conceptually similar to both inhibition and set-shifting. Though they serve different functions, all three are robustly associated with depression. Coping flexibility is the ability to relinquish a coping strategy regarded as ineffective and to devise and implement an alternative one; [...] Read more.

Coping flexibility is conceptually similar to both inhibition and set-shifting. Though they serve different functions, all three are robustly associated with depression. Coping flexibility is the ability to relinquish a coping strategy regarded as ineffective and to devise and implement an alternative one; the concept is based on stress and coping theory. Inhibition is the ability to suppress responses selectively according to a change in the situation, while set-shifting is the process of switching flexibly between task sets, mental sets, or response rules. Inhibition and set-shifting are both executive functions in cognitive mechanisms. We hypothesized that coping flexibility was associated with a lower risk of depression, even when the effects of inhibition and set-shifting were controlled for. In total, 200 Japanese university students (100 women and 100 men) completed questionnaires that measured coping flexibility and depression and performed the Stroop Color and Word Test and the Wisconsin Card Sorting Test, which measured inhibition and set-shifting. We found that greater coping flexibility was associated with a lower risk of depression, even when the effects of inhibition and set-shifting were controlled for. Our findings suggest that, although coping flexibility is conceptually similar to inhibition and set-shifting, its association with depression differs from theirs. Full article

(This article belongs to the Special Issue Depressive Disorders—Common Pathomechanisms of Somatic and Psychiatric Comorbidity)

Review

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11 pages, 249 KiB

Open AccessReview

Cognitive Behavioral Therapy of Patients with Somatic Symptoms—Diagnostic and Therapeutic Difficulties

by Agata Orzechowska, Paulina Maruszewska and Piotr Gałecki

J. Clin. Med. 2021, 10(14), 3159; https://doi.org/10.3390/jcm10143159 - 17 Jul 2021

Cited by 13 | Viewed by 8092

Abstract

In every somatic disease we can find a psychological element, just as it is not uncommon for numerous physical symptoms to occur in a mental disease. Nowadays, the patient is no longer just the “owner” of the sick organ but is considered and [...] Read more.

In every somatic disease we can find a psychological element, just as it is not uncommon for numerous physical symptoms to occur in a mental disease. Nowadays, the patient is no longer just the “owner” of the sick organ but is considered and treated as a “whole”. The interpenetration of somatic manifestations with mental health problems forces patients who experience subjective suffering, including mental suffering, from current symptoms to visit specialists from different fields of medicine, and their treatment does not bring about any improvement. Cognitive behavioral psychotherapy (CBT) is one form of therapy that attempts to respond to the needs of an increasing—in recent years—number of patients who demonstrate somatic disorders of a multifaceted nature. The co-occurrence of physical and mental disorders repeatedly makes it impossible to determine which symptoms were the cause and which were the effect; hence, it is difficult to establish clear boundaries between the categories of these disorders and diseases. The therapist, to whom the patient with somatic diseases is eventually referred, may be faced with a diagnostic dilemma, the solution of which will give direction to further psychotherapeutic work. The common feature of this group of patients is a strong focus on physical ailments, while omitting or almost completely ignoring the psychological factors involved. The purpose of this paper is to present the causally diverse circumstances in which a patient with physical symptoms needs diagnosis and therapeutic support from the perspective of a cognitive behavioral approach. Full article

(This article belongs to the Special Issue Depressive Disorders—Common Pathomechanisms of Somatic and Psychiatric Comorbidity)

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