Guest Commentary by Chi-Un Pae, MD, PhD
- Influence of RGS2 on Sertraline Treatment for Social Anxiety Disorder
- Assessment of Plasma C-Reactive Protein as a Biomarker of Posttraumatic Stress Disorder Risk
- A Meta-analysis of the Risk of Major Affective Disorder in Relatives of Individuals Affected by Major Depressive Disorder or Bipolar Disorder
- Omega-3 Fatty Acids in the Prevention of Interferon-Alpha-Induced Depression: Results from a Randomized, Controlled Trial
- Effect of Anxiolytic and Hypnotic Drug Prescriptions on Mortality Hazards: Retrospective Cohort Study
Stein MB, Keshaviah A, Haddad SA, et al
To evaluate several candidate genetic predictors of SSRI response in social anxiety disorder (SAD)
Variation in RGS2, a gene previously shown to be associated with social anxiety phenotypes and serotonergic neurotransmission, may be a biomarker of the likelihood of substantially benefiting from sertraline among patients with SAD.
Approximately 30% of depressed patients remit with initial antidepressant treatment. For the remaining patients, risk of recurrence significantly increases with each subsequent treatment failure. In this context, the present pharmacogenetic data are in line with the unmet need for predictive biomarkers of SSRI response in SAD for identifying responders and nonresponders before starting a treatment in clinical practice. However, additional research is mandatory to support and replicate this finding.
Eraly SA, Nievergelt CM, Maihofer AX, et al
JAMA Psychiatry. 2014 Feb 26
To determine whether plasma concentration of the inflammatory marker C-reactive protein (CRP) helps predict posttraumatic stress disorder (PTSD) symptoms
A marker of peripheral inflammation, plasma CRP may be prospectively associated with PTSD symptom emergence, suggesting that inflammation may predispose to PTSD.
The present study is in line with the hypothesis that PTSD may be predisposed by a dysregulation of the stress axis resulting in disinhibition of pro-inflammatory pathways. The strengths of the study are a huge sample size, prospective design, and adjustment for multiple potential confounders. The present study at least indicates that treatment with dietary or lifestyle modifications, which are associated with a decrease of inflammation, may effectively ameliorate the severity of this disorder. Further, such interventions can be combined with traditional pharmacological treatments, possibly leading to better treatment outcomes.
Wilde A, Chan HN, Rahman B, et al
J Affect Disord. 2014;158:37-47
To conduct a meta-analysis to estimate the incidence of major depressive disorder (MDD) and bipolar disorder (BD) in first-degree relatives (FDRs) of probands affected by MDD or BD
This is the first meta-analysis investigating familial loading for BD, and the first meta-analysis of shared genetic vulnerability for MDD and BD, and risk of MDD in more than one proband. The present meta-analysis includes data from 22 case-control and cohort studies, which investigated odds of MDD or BD in 10,859 relatives of probands with diagnoses of MDD or BD. The present meta-analysis confirms that elevated family loading remains the best predictive risk factor for MDD and BD. The need of development of a vulnerability index tailored to familial loading of affective disorders would be necessary and very helpful for better understanding of those risk factors and future researches.
Su KP, Lai HC, Yang HT, et al
Biol Psychiatry. 2014 Jan 24. pii: S0006-3223(14)00047-X
To investigate the effects of Omega-3 polyunsaturated fatty acids (FAs) in patients with interferon (IFN)-α induced depression since the lower erythrocyte levels of FAs were found to be associated with an increased risk of such clinical condition
The EPA pretreatment significantly decreased the incidence of IFN-α-induced depression in HCV patients. In addition, both EPA and DHA pretreatment significantly delayed the onset of IFN-α-induced depression as compared with placebo pretreatment.
Emerging evidence consistently support the utility of FAs in the treatment of patients with depression as one of promising complimentary medicines, in particular, for depressed patients with partial response or tolerability issues from antidepressant treatment. In this context, this is the first study to demonstrate the beneficial effects of FAs in the prevention of IFN-α-induced depression. This study has a direct clinical relevance in that HCV patients receiving IFN-α may have some limitations in the use of contemporary antidepressants such as SSRIs due to safety and tolerability issues; FAs may possibly provide such patients with a safe and well-accepted alternative antidepressant treatment. However, conclusive remark on the exact role of FAs in the treatment of IFN-α-induced depression should be cautious till today since these findings should need to be supported by more adequately-powered and well-designed clinical trials.
Weich S, Pearce HL, Croft P, et al.
BMJ. 2014 Mar 19;348:g1996
To test the hypothesis that people taking anxiolytic and hypnotic drugs are at increased risk of premature mortality, using primary care prescription records and after adjusting for a wide range of potential confounders
In this large cohort study, anxiolytic and hypnotic drugs were associated with significantly increased risk of mortality over a 7-year period, after adjusting for a range of potential confounders. These results are cautiously interpreted due to potential bias arising from unmeasured and residual confounding.
The greatest strength of the present study is the use of a large data from the General Practice Research Database, based on its sample size, representativeness of the sample, data completeness, and duration of the follow-up. These findings are consistent with previous evidence of a statistically and clinically significant association between anxiolytic and hypnotic drugs and mortality. However, cohort studies are also prone to immortal time bias, which arises if the period participants are considered at risk differs between comparator groups.