Cristiano Tschiedel Belem da Silva

Neurobiological effects of exercise on major depressive disorder: A systematic review

Exercise displays promise as an efficacious treatment for people with depression. However, no systematic review has evaluated the neurobiological effects of exercise among people with major depressive disorder (MDD). The aim of this article was to systematically review the acute and chronic biological responses to exercise in people with MDD. Two authors conducted searches using Medline (PubMed), EMBASE and PsycINFO. From the searches, twenty studies were included within the review, representing 1353 people with MDD. The results demonstrate that a single bout of exercise increases atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), copepetin and growth hormone among people with MDD. Exercise also potentially promotes long-term adaptations of copeptin, thiobarbituric acid reactive species (TBARS) and total mean frequency (TMF). However, there is limited evidence that exercise promotes adaptations on neurogenesis, inflammation biomarkers and brain structure. Associations between depressive symptoms improvement and hippocampus volume and IL-1β were found. Nevertheless, the paucity of studies and limitations presented within, precludes a more definitive conclusion of the underlying neurobiological explanation for the antidepressant effect of exercise in people with MDD. Further trials should utilize appropriate assessments of neurobiological markers in order to build upon the results of our review and further clarify the potential mechanisms associated with the antidepressant effects of exercise.

Anxiety disorders in adolescence are associated with impaired facial expression recognition to negative valence

OBJECTIVE The aim of the present study was to test the ability of adolescents with a current anxiety diagnosis to recognize facial affective expressions, compared to those without an anxiety disorder. METHODS Forty cases and 27 controls were selected from a larger cross sectional community sample of adolescents, aged from 10 to 17 years old. Adolescents facial recognition of six human emotions (sadness, anger, disgust, happy, surprise and fear) and neutral faces was assessed through a facial labeling test using Ekmans Pictures of Facial Affect (POFA). RESULTS Adolescents with anxiety disorders had a higher mean number of errors in angry faces as compared to controls: 3.1 (SD=1.13) vs. 2.5 (SD=2.5), OR=1.72 (CI95% 1.02 to 2.89; p=0.040). However, they named neutral faces more accurately than adolescents without anxiety diagnosis: 15% of cases vs. 37.1% of controls presented at least one error in neutral faces, OR=3.46 (CI95% 1.02 to 11.7; p=0.047). No differences were found considering other human emotions or on the distribution of errors in each emotional face between the groups. CONCLUSION Our findings support an anxiety-mediated influence on the recognition of facial expressions in adolescence. These difficulty in recognizing angry faces and more accuracy in naming neutral faces may lead to misinterpretation of social clues and can explain some aspects of the impairment in social interactions in adolescents with anxiety disorders.

Somatic, but not cognitive, symptoms of anxiety predict lower levels of physical activity in panic disorder patients

BACKGROUND Anxiety disorders have gathered much attention as possible risk factors for the development of cardiovascular disease (CVD), possibly mediated by an unhealthy lifestyle (e.g. low physical activity). However, prospective studies on anxiety disorders and CVD show conflicting results. A possible explanation is that somatic symptoms of anxiety may have a more specific cardiovascular effect than cognitive symptoms across different anxiety disorders. The present study investigated the association between cognitive and somatic symptoms of anxiety and physical activity (PA) in a sample of panic disorder (PD) outpatients. METHODS One-hundred and two outpatients with a lifetime diagnosis of PD from a previously studied cohort were contacted. Patients were evaluated throughout the MINI, the Beck Anxiety Inventory (BAI) and the International Physical Activity Questionnaire (IPAQ). After performing a multivariate regression analysis, groups were divided into high and low somatic anxiety. RESULTS Patients with high somatic anxiety showed a significantly higher prevalence of low level of PA as compared to those with low somatic anxiety (62.5 versus 34.3%; χ²= 5.33; df=1; P=.021). Somatic symptoms of anxiety remained the only important predictors of low level of PA (odds ratio [OR] 2.81; 95% CI 1.00-7.90; p=.050) in the multivariate model. LIMITATIONS The main limitations of the present study are the cross-sectional design and the small sample size. CONCLUSIONS Results support specific effects of somatic symptoms of anxiety on risk for low level of PA, which might explain inconsistent results regarding CVD risk in the literature.

Family burden and family environment: comparison between patients with panic disorder and with clinical diseases.

The objective of this study was to compare the family burden and environment of patients with panic disorder (PD) with those of a control group composed of relatives of patients with clinical diseases.

From brain to heart: a (not so) long way to go

Anxiety disorders are among the most prevalent and disabling psychiatric conditions [1]. Recent studies have linked these disorders to cardiovascular risk factors and chronic diseases [2], possibly mediated by a range of factors, including inflammation [3]. These important associations have been extensively investigated in patients with major depression. Albeit, depression and anxiety are highly comorbid and respond to similar pharmacological treatment, it remains unclear what their shared risk factors are and to what extent the underlying inflammatory mechanisms could play a causal role. Moreover, the influence of stress in inflammatory response and in the hypothalamic–pituitary–adrenal axis functioning is associated with both depressive and anxiety disorders. The previous being said, the interplay amidst anxiety, inflammation and cardiovascular outcomes should be of interest and are discussed in the present study.

Attention, memory, visuoconstructive, and executive task performance in adolescents with anxiety disorders: a case-control community study

Objective: The aim of the present study was to assess children and adolescents with mild and severe anxiety disorders for their performance in attention, verbal episodic memory, working memory, visuoconstructive skills, executive functions, and cognitive global functioning and conduct comparative analyses with the performance of children free from anxiety disorders. Methods: Our sample comprised 68 children and adolescents aged 10 to 17 years (41 with current diagnoses of anxiety disorders and 27 controls) selected from a larger cross-sectional community sample of adolescents. Children and adolescents with anxiety disorders were categorized into two groups on the basis of anxiety severity (mild or severe). All participants underwent a neuropsychological assessment battery to evaluate attention, verbal episodic memory, working memory, visuoconstructive skills, and executive and cognitive functions. Results: No differences were found in any neuropsychological tests, with the single exception that the group with mild anxiety had better performance on the Digit Span backward test compared to subjects with severe anxiety and to controls (p = 0.041; η2 = 0.11). Conclusions: Not only might anxiety disorders spare main cognitive functions during adolescence, they may even enhance certain working memory processes.

Inflammation and internalizing disorders in adolescents

ABSTRACT Serum inflammatory markers have been studied in adults with anxiety and depression, but little is known about cytokine levels in young adolescents with emotional disorders. The objective of this study is to compare serum levels of interleukin‐6 (IL‐6) and interleukin‐10 (IL‐10) between adolescents with internalizing disorders and adolescents from the same community without internalizing disorders. A total of 134 non‐medicated subjects (n = 76 with internalizing disorders) were recruited from a larger sample of 2457 individuals. Serum levels of IL‐6 and IL‐10 were quantified and psychiatric diagnosis was evaluated using structured clinical interviews. Adolescents with internalizing disorders presented significantly higher levels of IL‐6 as compared to youngsters without internalizing disorders. Differences between groups in IL‐10 levels were not statistically significant. This study points out that IL‐6 levels may be associated with internalizing disorders in youths and suggests that inflammation might be an early biomarker of emotional distress. High levels of cytokines may adversely affect general health in the long‐term, which raise broader issues in terms of public health if results are replicated. HIGHLIGHTSHigher IL‐6 levels were found in adolescents with internalizing disorders.No significant differences were found for IL‐10 levels.Inflammation might be an early biomarker of internalizing disorders.

Factors that influence the neurobiological effects of exercise likely extend beyond age and intensity in people with major depression

We recently conducted a comprehensive systematic review of neurobiological effects of exercise on major depressive disorder. A subsequent letter suggested that we should consider children and adolescent and raised the importance of how intensity may mediate neurobiological response in people with depression. Here, we discuss these comments regarding our review, in addition to proposing that other factors, such type, duration, frequency, and adherence, may also importantly influence neurobiological response, based on recent meta-analyses demonstrating these other aspects of physical activity also moderate dropout rates and effect sizes from exercise upon depression.

Panic Disorder and Cardiovascular Death: What Is Beneath?

Considering extensive overlap among symptoms of panic disorder (PD) and cardiovascular diseases (CVD), the fact that so little attention has been drawn to studies addressing the relationship between both so far is somewhat intriguing. Therefore, this chapter will focus on the issue considering several perspectives. It starts delineating an historical background, showing that the interest on studying the relationship between anxiety symptoms and CVD began more than a century ago. Next, epidemiological research is reviewed, but considering lack of consistent findings, anxiety disorders and, more specifically, PD are deconstructed. Not only this, but biological mechanisms that could link anxiety symptoms and CVD, such as pleiotropy, heart rate variability, unhealthy lifestyle and atherosclerosis, are also explored. The chapter ends highlighting the importance of reversibility, that is, if PD and CVD are somewhat connected, intervention studies should prove the utility of prevention. As can be seen, the text is constructed using an epistemological perspective, since it constitutes a major area of indagation and research of the authors and is meant to raise the same sort of questioning in the readers.

Adiposity during adolescence and carotid intima-media thickness in adulthood: Results from the 1993 Pelotas Birth Cohort

Background and aims Although several studies have examined the association between adiposity and cardiovascular risk markers, few have explored the issue prospectively in young populations. We sought to test whether higher levels of body mass index (BMI) and subscapular skinfold at different stages of adolescence were associated with carotid intima-media thickness (cIMT) in young adulthood. Methods In a prospective cohort, we assessed BMI and subscapular skinfold at 11, 15 and 18 years and measured cIMT at 18 years in 3264 individuals. Traditional cardiovascular risk factors and fat mass-mediating effects on cIMT were also assessed. Results Both BMI and subscapular skinfolds were significantly associated with higher cIMT in a cummulative fashion: after controlling for confounders, males and females who persisted overweight/obese at all three assessments, had a mean higher cIMT (5.2 and 3.1 μm, respectively) compared to males and females with normal/healthy BMI at each evaluation (p < 0.001). Moreover, male and females that presented increased fatness in all assessments had a similar pattern of higher cIMT compared to normal/healthy fatness/skinfold at 18 years (mean cIMT 4.6 and 3.0 μm for males and females, respectively; p < 0.001). Associations between adiposity and cIMT were both direct and indirect. Indirect effects were chiefly mediated by fat mass and diastolic blood pressure. Conclusions Our results suggest adiposity exerts direct and indirect effects during adolescence that result in higher cIMT in young adulthood.