Identification and Validation of Urinary Metabolite Biomarkers for Major Depressive Disorder.

Identification and validation of urinary metabolite biomarkers for major depressive disorder.

Filed under: Depression Treatment

Mol Cell Proteomics. 2012 Oct 30;
Zheng P, Wang Y, Chen L, Yang D, Meng H, Zhou D, Zhong J, Lei Y, Melgiri N, Xie P

Major depressive disorder (MDD) is a widespread and debilitating mental disorder. However, there are no biomarkers available to aid in the diagnosis of this disorder. In this study, a nuclear magnetic resonance spectroscopy-based metabonomic approach was employed to profile urine samples from 82 first-episode drug-naive depressed subjects and 82 healthy controls (the training set) in order to identify urinary metabolite biomarkers for MDD. Then, 44 unselected depressed subjects and 52 healthy controls (the test set) were used to independently validate the diagnostic generalizability of these biomarkers. A panel of five urinary metabolite biomarkers (malonate, formate, N-methylnicotinamide, m-hydroxyphenylacetate, and alanine) was identified. This panel was capable of distinguishing depressed subjects from healthy controls with an area under the receiver operating characteristic curve (AUC) of 0.81 in the training set. Moreover, this panel could classify blinded samples from the test set with an AUC of 0.89. These findings demonstrate that this urinary metabolite biomarker panel can aid in the future development of a urine-based diagnostic test for MDD.
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Single-agent duloxetine ingestions.

Filed under: Depression Treatment

Hum Exp Toxicol. 2012 Oct 30;
Jacob J, Albert D, Heard K

Duloxetine is a serotonin and norepinephrine reuptake inhibitor, which is mainly used to treat depression. This retrospective study describes the demographic and clinical effects of duloxetine ingestions reported to the National Poison Data System (NPDS). NPDS data were searched for duloxetine exposures between 2004 and 2010. A total of 11,373 patients were included and exposures were divided into three groups of ages ?6 years old, 7-12 years and >12 years. Neurological clinical effects occurred in 6.1% of the patients aged ?6 years, 13.0% of the patients aged 7-12 years and 24.6% of the patients aged >12 years. Cardiovascular effects occurred in 1.4% of the patients aged ?6 years old, 2.5% of the patients aged 7-12 years and 11.6% of the patients aged >12 years. Gastrointestinal effects occurred in 4.1% of the patients aged ?6 years old, 16.6% of the patients aged 7-12 years and 13.8% of the patients aged >12 years. Tachycardia, nausea, vomiting, agitation/irritability, dizziness/vertigo and drowsiness were among the most common clinical effects in all three groups. Overall, 61.4% of the patients aged ?6 years and 77.5% of the patients aged 7-12 years were managed in a non-health care facility, while 55.8% of the patients aged >12 years were referred to or already in a health care facility. We conclude that the majority of ingestions are benign in both pediatrics and adults. Most symptomatic patients have neurologic, gastrointestinal and cardiovascular effects. Most pediatric patients will be able to be managed in a non-health care facility.
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Impaired functional status in primary Sjögren’s syndrome.

Filed under: Depression Treatment

Arthritis Care Res (Hoboken). 2012 Nov; 64(11): 1760-4
Hackett KL, Newton JL, Frith J, Elliott C, Lendrem D, Foggo H, Edgar S, Mitchell S, Ng WF

Several studies have demonstrated that primary Sjögren’s syndrome (SS) is associated with reduced productivity; however, the impact of primary SS on daily function is not fully understood. This study aims to assess the physical function of primary SS patients and determine the relationship between the functional impairment experienced by primary SS patients and disease activity, patient-reported symptoms, and quality of life.Sixty-nine primary SS patients from a specialist clinical service were assessed for their functional ability (Improved Health Assessment Questionnaire [HAQ]), dryness, pain, and overall primary SS-related symptom burden; systemic disease activity; levels of fatigue, daytime somnolence, anxiety, and depression symptoms; quality of life; and systemic inflammation (erythrocyte sedimentation rate, C-reactive protein [CRP] level). Data were compared to 69 healthy volunteers matched for age and sex.Primary SS patients experienced greater functional impairment than controls (Improved HAQ total scores: mean ± SD 24 ± 25 for primary SS versus 9 ± 19 for controls; P = 0.0002) across all domains of activity. In primary SS, functional impairment was significantly associated with physical fatigue (P < 0.0001, R(2) = 0.3), pain (P < 0.0001, R(2) = 0.3), depression (P < 0.0001, R(2) = 0.3), total symptom burden (P < 0.0001, R(2) = 0.3), systemic disease activity (P = 0.002, R(2) = 0.15), quality of life (P < 0.0001, R(2) = 0.3), dryness (P = 0.002, R(2) = 0.12), daytime somnolence (P = 0.02, R(2) = 0.08), anxiety score (P = 0.03, R(2) = 0.07), and CRP level (P = 0.04, R(2) = 0.06). Only CRP level is independently associated with functional impairment (? = 0.38, P = 0.025).Primary SS patients experience significant functional disability compared to age-matched healthy controls. Impaired function is associated with reduced quality of life and symptoms such as pain, fatigue, and depression, as well as disease activity, illustrating the importance of optimal management of all aspects of the disease. HubMed – depression

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