Stress, inflammation, and cellular vulnerability during early stages of affective disorders: biomarker strategies and opportunities for prevention and intervention

The mood disorder prodrome is conceptualized as a symptomatic, but not yet clinically diagnosable stage of an affective disorder. Although a growing area, more focused research is needed in the pediatric population to better characterize psychopathological symptoms and biological markers that can reliably identify this very early stage in the evolution of mood disorder pathology. Such information will facilitate early prevention and intervention, which has the potential to affect a person’s disease course.This review focuses on the prodromal characteristics, risk factors, and neurobiological mechanisms of mood disorders. In particular, we consider the influence of early-life stress, inflammation, and allostatic load in mediating neural mechanisms of neuroprogression. These inherently modifiable factors have known neuroadaptive and neurodegenerative implications, and consequently may provide useful biomarker targets. Identification of these factors early in the course of the disease will accordingly allow for the introduction of early interventions which augment an individual’s capacity for psychological resilience through maintenance of synaptic integrity and cellular resilience. A targeted and complementary approach to boosting both psychological and physiological resilience simultaneously during the prodromal stage of mood disorder pathology has the greatest promise for optimizing the neurodevelopmental potential of those individuals at risk of disabling mood disorders.

Analysis of circadian rhythms from online communities of individuals with affective disorders

The circadian system regulates 24 hour rhythms in biological creatures. It impacts mood regulation. The disruptions of circadian rhythms cause destabilization in individuals with affective disorders, such as depression and bipolar disorders. Previous work has examined the role of the circadian system on effects of light interactions on mood-related systems, the effects of light manipulation on brain, the impact of chronic stress on rhythms. However, such studies have been conducted in small, preselected populations. The deluge of data is now changing the landscape of research practice. The unprecedented growth of social media data allows one to study individual behavior across large and diverse populations. In particular, individuals with affective disorders from online communities have not been examined rigorously. In this paper, we aim to use social media as a sensor to identify circadian patterns for individuals with affective disorders in online communities.We use a large scale study cohort of data collecting from online affective disorder communities. We analyze changes in hourly, daily, weekly and seasonal affect of these clinical groups in contrast with control groups of general communities. By comparing the behaviors between the clinical groups and the control groups, our findings show that individuals with affective disorders show a significant distinction in their circadian rhythms across the online activity. The results shed light on the potential of using social media for identifying diurnal individual variation in affective state, providing key indicators and risk factors for noninvasive wellbeing monitoring and prediction.

Subjective wellbeing as an affective construct

The affective component of Subjective Wellbeing (SWB) was investigated according to the Circumplex model of affect. Structural equation modelling demonstrated that affect is the dominant component of SWB and it is concluded that core affect is the central component of SWB, and the driving force behind SWB homeostasis.

Staging systems in bipolar disorder: an International Society for Bipolar Disorders Task Force report

We discuss the rationale behind staging systems described specifically for bipolar disorders. Current applications, future directions and research gaps in clinical staging models for bipolar disorders are outlined.

Discovering latent affective dynamics among individuals in online mental health-related communities

Discovering dynamics of emotion and mood changes for individuals has the potential to enhance the diagnosis and treatment of mental disorders. In this paper we study affective transitions and dynamics among individuals in online mental health communities. Using social media as form of 'sensor', we crawl a large dataset of blogs posted by online communities whose descriptions declared to be associated with affective disorder conditions such as depression, anxiety, or autism. We then apply nonnegative matrix factorization model to extract the common and individual factors of affective transitions across groups of individuals in different levels of affective disorders. We examine the latent patterns of emotional transitions and investigate the effects of emotional transitions across the cohorts. Our framework is novel as it utilizes social media as an online sensing platform of mood and emotional dynamics. Hence, our work has implication in constructing systems to screen individuals and communities at high risks of mental health problems in online settings.

Socio-cultural messages, body image, and body change strategies in men

The thesis found that men received information about the ideal male body from perceived media messages and peers through encouragement, teasing, or modelled behaviours. Body mass index (BMI) also influenced participant's perceptions of their body-image and the strategies they used to change their shape. Sexual partners generally held positive views of men's body shape and weight. The portfolio examines the barriers experienced by individuals with co-occuring disorders within the current treatment system, by analysing four case studies.

Lower levels of physical activity in childhood associated with adult depression

Emerging evidence indicates that early life exposures influence adult health outcomes and there is cause to hypothesise a role for physical activity (PA) in childhood as a protective factor in adult depression. This study aimed to investigate the association between self-reported levels of PA in childhood and self-reported depressive illness. Lifetime depression and levels of physical activity (low/high) in childhood (<15 yr) were ascertained by self-report in 2152 adults (20–97 yr) participating in an ongoing epidemiological study in south-eastern Australia. Data were collected between 2000 and 2006. In this sample, 141 women (18.9%) and 169 men (12.0%) reported ever having a depressive episode. Low PA in childhood was associated with an increased risk of reporting depression in adulthood (OR = 1.70, 95%CI = 1.32–2.17, p < 0.001). Adjustment for age, gender and adult PA attenuated the relationship somewhat (OR = 1.35, 95%CI = 1.01–1.78, p = 0.04), however further adjustment for SES or country of birth did not affect this relationship. In this community-based study, lower levels of self-reported PA in childhood were associated with a 35% increase in odds for self-reported depression in adulthood. These results are consistent with the hypothesis that lower levels of PA in childhood may be a risk factor for adult depression.

Illness burden and medical comorbidity in the systematic treatment enhancement program for bipolar disorder

Objective:  Coexisting chronic medical conditions are common in bipolar disorder. Here, we report the prevalence and correlates of medical comorbidity in patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). We were particularly interested in associations between variables reflecting illness chronicity and burden with comorbid medical conditions.

Method:  We used intake data from the open-label component of the STEP-BD. History of medical comorbidity was obtained from the affective disorders evaluation, and its presence was the outcome of interest. The sample size in analyses varied from 3399 to 3534. We used multiple Poisson regression to obtain prevalence ratios.

Results:  The prevalence of any medical comorbidity in the sample was 58.8%. In addition to demographic variable, several clinical characteristics were associated with the frequency of medical comorbidity. Having more than 10 previous mood episodes, childhood onset, smoking, lifetime comorbidity with anxiety, and substance use disorders were independently associated with having a medical comorbidity in the final multivariate model.

Conclusion:  The results presented here reveal strong associations between variables related to illness chronicity and medical burden in bipolar disorder. This lends further support to recent multidimensional models incorporating medical morbidity as a core feature of bipolar disorder.

Fish oil diet associated with acute reperfusion related hemorrhage, and with reduced stroke-related sickness behaviors and motor impairment

Ischemic stroke is associated with motor impairment and increased incidence of affective disorders such as anxiety/clinical depression. In non-stroke populations, successful management of such disorders and symptoms has been reported following diet supplementation with long chain omega-3-polyunsaturated-fatty-acids (PUFAs). However, the potential protective effects of PUFA supplementation on affective behaviors after experimentally induced stroke and sham surgery have not been examined previously. This study investigated the behavioral effects of PUFA supplementation over a 6-week period following either middle cerebral artery occlusion or sham surgery in the hooded-Wistar rat. The PUFA diet supplied during the acclimation period prior to surgery was found to be associated with an increased risk of acute hemorrhage following the reperfusion component of the surgery. In surviving animals, PUFA supplementation did not influence infarct size as determined 6 weeks after surgery, but did decrease omega-6-fatty-acid levels, moderate sickness behaviors, acute motor impairment, and longer-term locomotor hyperactivity and depression/anxiety-like behavior.

The role of genetics in suicide and the link with major depression and alcoholism.

A clear genetic influence in suicide has been established. In addition, both the serotonergic and noradrenergic systems appear to have a role in suicide, mood disorders and alcoholism. This paper reviews some of the genes that may possibly be involved in suicide and their link to major depression and alcoholism. The genes that are reviewed act on various enzymes within the serotonergic and catecholaminergic systems. With further study, these entities may form a spectrum along the same disease process associated with variable expressivity of the responsible genes.

Supersensitive platelet glutamate receptors as a possible peripheral marker in schizophrenia.

Hypoglutamatergic function is implicated in the pathogenesis of schizophrenia. The aim of this study was to examine the platelet intracellular calcium response to glutamate using spectroflourometry in 15 schizophrenic patients and 15 matched control individuals as an index of platelet glutamate receptor sensitivity. Patients with schizophrenia had significantly lower baseline intracellular calcium levels than matched control individuals (P = 0.03). The percentage response of the schizophrenic individuals to glutamate stimulation was significantly greater than control individuals (P < 0.001). These data suggest that platelet glutamate receptors may be supersensitive in schizophrenia. Furthermore, the platelet may be a possible peripheral marker of glutamate function in schizophrenia.

Nonparametric discovery of online mental health-related communities

People are increasingly using social media, especially online communities, to discuss mental health issues and seek supports. Understanding topics, interaction, sentiment and clustering structures of these communities informs important aspects of mental health. It can potentially add knowledge to the underlying cognitive dynamics, mood swings patterns, shared interests, and interaction. There has been growing research interest in analyzing online mental health communities; however sentiment analysis of these communities has been largely under-explored. This study presents an analysis of online Live Journal communities with and without mental health-related conditions including depression and autism. Latent topics for mood tags, affective words, and generic words in the content of the posts made in these communities were learned using nonparametric topic modelling. These representations were then input into a nonparametric clustering to discover meta-groups among the communities. The best performance results can be achieved on clustering communities with latent mood-based representation for such communities. The study also found significant differences in usage latent topics for mood tags and affective features between online communities with and without affective disorders. The findings reveal useful insights into hyper-group detection of online mental health-related communities.

Effects of affective and anxiety disorders on outcome in problem gamblers attending routine cognitive-behavioural treatment in South Australia

This study evaluated the influence of 12-month affective and anxiety disorders on treatment outcomes for adult problem gamblers in routine cognitive–behavioural therapy. A cohort study at a state-wide gambling therapy service in South Australia. Primary outcome measure was rated by participants using victorian gambling screen (VGS) ‘harm to self’ sub-scale with validated cut score 21? (score range 0–60) indicative of problem gambling behaviour. Secondary outcome measure was Work and Social Adjustment Scale (WSAS). Independent variable was severity of affective and anxiety disorders based on Kessler 10 scale. We used propensity score adjusted random-effects models to estimate treatment outcomes for sub-populations of individuals from baseline to 12 month follow-up. Between July, 2010 and December, 2012, 380 participants were eligible for inclusion in the final analysis. Mean age was 44.1 (SD = 13.6) years and 211 (56 %) were males. At baseline, 353 (92.9 %) were diagnosed with a gambling disorder using VGS. For exposure, 175 (46 %) had a very high probability of a 12-month affective or anxiety disorder, 103 (27 %) in the high range and 102 (27 %) in the low to moderate range. For the main analysis, individuals experienced similar clinically significant reductions (improvement) in gambling related outcomes across time (p\0.001). Individuals with co-varying patterns of problem gambling and 12 month affective and anxiety disorders who present to a gambling help service for treatment in metropolitan South Australia