The effects of temperament on depression according to the schema model: a scoping review

Background: Recent studies have shown that not every depressed patient responds to Cognitive Behavioral Therapy, and some of those who do relapse upon termination. Due to its dual focus on the past and present, Schema Model (SM) represents a promising alternative model to understand depression. However, studies examining SM often operationalize the same construct differently, resulting in inconsistent evidence of change. There is no known review clarifying (1) how best to assess schema constructs; and (2) the relevant pathways to depression, without which, the empirical basis for SM cannot be examined. Methods: A scoping review was conducted in accordance to PRISMA guidelines to map evidence of the relationship between constructs of SM and depression, and measures used to assess the constructs. 2463 articles were identified with 49 primary research studies included. This paper is a subset of the scoping review and focuses on the five studies examining effects of temperament on depression. Results: Two models were used to operationalize temperament: The Five Factor Model (FFM) and the Psychobiological Model of Personality (PBM). The variables of neuroticism and harm avoidance were positively associated with depressive symptoms while self-directedness and cooperativeness were negative associated with depressive symptoms. Conclusion: The FFM is more suited to operationalize temperament in studies of SM and depression due to its theoretical compatibility with SM, established psychometric properties of its measures, and widespread use among studies of SM. Out of the five factors in the FFM, only neuroticism exerts direct and indirect effects on depression. These findings are limited by homogeneous sampling, hence future research studies should consider extending it to adult clinical samples. Nevertheless, this review represents a first step in the systematic examination of the empirical basis of SM and a contribution to treatment innovation and practice for depression

Predicting Opioid Use Outcomes in Minoritized Communities

Machine learning algorithms can sometimes exacerbate health disparities based on ethnicity, gender, and other factors. There has been limited work at exploring potential biases within algorithms deployed on a small scale, and/or within minoritized communities. Understanding the nature of potential biases may improve the prediction of various health outcomes. As a case study, we used data from a sample of 539 young adults from minoritized communities who engaged in nonmedical use of prescription opioids and/or heroin. We addressed the indicated issues through the following contributions: 1) Using machine learning techniques, we predicted a range of opioid use outcomes for participants in our dataset; 2) We assessed if algorithms trained only on a majority sub-sample (e.g., Non-Hispanic/Latino, male), could accurately predict opioid use outcomes for a minoritized sub-sample (e.g., Latino, female). Results indicated that models trained on a random sample of our data could predict a range of opioid use outcomes with high precision. However, we noted a decrease in precision when we trained our models on data from a majority sub-sample, and tested these models on a minoritized sub-sample. We posit that a range of cultural factors and systemic forms of discrimination are not captured by data from majority sub-samples. Broadly, for predictions to be valid, models should be trained on data that includes adequate representation of the groups of people about whom predictions will be made. Stakeholders may utilize our findings to mitigate biases in models for predicting opioid use outcomes within minoritized communities

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

The relationship between systemic lupus erythematosus and psychiatric morbidity

SLE is associated with neuropsychiatric (NP) symptoms. The roles of various genotypes and autoantibodies (Abs) in NPSLE remain unknown. Before overt central nervous system (CNS) involvement, it is important to study the psychiatric morbidity, cognitive functions, structural and functional changes in the brain in SLE patients. Two meta-analyses were performed to understand the aetiology and pathogenesis of NPSLE. The first meta-analysis identified that genetic polymorphisms in the pathways of immune complex clearance, such as the IgG Fc (Fcγ) receptor IIIa, Fcγ RIIIb and Integrin alpha M (ITGAM) genotypes were found to be susceptibility genes for NPSLE. The second meta-analysis found that NPSLE patients are more likely to have elevated serum levels of anti-cardiolipin (AcL), lupus anticoagulants (LA), anti-phospholipid (APL), anti-ribosomal P Abs and anti-neuronal Abs compared with SLE patients without NP manifestations. Clinical studies were performed on SLE patients without overt CNS involvement. A cross-sectional study comparing depression, anxiety and health status in patients suffering from SLE, rheumatoid arthritis (RA) and gout found that SLE patients were more likely to be anxious compared to RA and gout patients. Impaired mental health and a low satisfaction with life were significantly associated with anxiety in SLE patients. The relationship between illness perception, rumination and negative emotions/fatigue in patients with RA and SLE were examined. SLE patients reported higher levels of perceived chronicity of illness, rumination and anxiety compared to RA patients. Identity, causes and consequences of illness, were associated with a greater severity of negative emotions and fatigue in patients suffering from RA and SLE and mediated by ruminations. When comparing the cognitive function in SLE patients and healthy controls, SLE patients with high levels of anxiety/depression demonstrated significantly lower processing speeds and visuospatial constructional abilities compared to SLE patients with low levels of anxiety/depression and healthy controls. When performing a set-shifting task during functional magnetic resonance imaging (fMRI), SLE patients demonstrated increased shift-related activations in the frontal and parietal areas. The shift-related deactivations in the anterior cingulate gyrus in SLE patients suggest impaired attentional network for conflict and error detection. The shift-related deactivations in the hippocampus infer that there are early damages in the hippocampus in SLE. As compared to healthy controls, structural MRI analysis revealed significant reductions in the grey matter volumes (GMV) at baseline and 16-month follow-up in the left inferior temporal gyrus, the right middle frontal gyrus, orbital part, the right superior frontal gyrus, the right rolandic operculum, the bilateral inferior frontal gyrus, orbital part and the bilateral middle cingulate cortex, as well as in the white matter volumes (WMV) at baseline and 16-month follow-up in the bilateral superior longitudinal fasciculus, the bilateral corticospinal tract, the bilateral cingulum cingulated gyrus, the bilateral inferior fronto-occipital fasciculus and the bilateral anterior thalamic radiation. This thesis discovers new findings to help liaison psychiatrists and rheumatologists to understand the pathogenesis in NPSLE and psychiatric morbidity in SLE without overt CNS involvement. Most importantly, this thesis provides a platform for further research in the non-organic, non-psychotic psychopathology of SLE.published_or_final_versionPsychiatryMasterDoctor of Medicin

25-Hydroxyvitamin D3 Deficiency Independently Predicts Cognitive Impairment in Patients with Systemic Lupus Erythematosus.

Cognitive dysfunction has been reported in 20-80% of SLE patients. Converging evidence has indicated the importance of vitamin D as a neuroimmunomodulator for cognitive function. In this study, we evaluated the relationship between vitamin D and cognitive dysfunction.Consecutive age- and gender-matched SLE patients and healthy controls (HCs) were administered Automated Neuropsychological Assessment Metrics in this cross-sectional study. The primary outcome was the total throughput score (TTS). Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Levels of 25-hydroxyvitamin D [25(OH)D3 and total 25(OH)D] were measured using Liquid Chromatography-Tandem Mass Spectrometry.In total, 61 SLE patients and 61 HCs were studied. SLE patients scored significantly lower than HCs in the TTS (p = 0.004). There were no statistically significant differences in 25(OH)D3 levels, total 25(OH)D levels and total 25(OH)D deficiency between SLE patients and HCs. However, more SLE patients had 25(OH)D3 deficiency compared to HCs [12 (19.7%) versus 2 (3.3%), p = 0.003]. Deficiency of 25(OH)D3 (β = -63.667, SE = 27.456, p = 0.025), but not other vitamin D variables, independently predicted worse TTS after adjusting for age, education, gender, ethnicity, HADS-Total, duration of SLE, SELENA-SLEDAI, SLICC/ACR Damage Index and cumulative steroid dose in SLE patients. Age (β = -4.261, SE = 0.866, p < 0.001) was the only predictor of TTS after adjusting for education, gender, ethnicity, HADS-Total, vitamin D levels or status in HCs.Deficiency of 25(OH)D3, a potentially modifiable risk factor, independently predicted cognitive impairment in SLE patients

Mean throughput scores in SLE patients and HCs.

<p>Higher scores represent better performance. The individual test data points for each group are connected for illustration purposes only. *P<0.05; **P<0.01.</p

Total throughput scores in relation to 25(OH)D₃ status in SLE patients.

<p>Box represents 25^th and 75^th percentiles, horizontal line represents the median, error bars show the 5^th and 95^th percentile and outside values are shown as dots. F(2,52) = 3.73, p = 0.031.</p

Results of multiple linear regression analysis between total throughput score and demographic, neuropsychological and clinical variables for 61 SLE patients.

<p>Results of multiple linear regression analysis between total throughput score and demographic, neuropsychological and clinical variables for 61 SLE patients.</p

Results of multiple linear regression analysis between total throughput score and demographic, neuropsychological and clinical variables for 61 SLE patients and 61 healthy controls.

<p>Results of multiple linear regression analysis between total throughput score and demographic, neuropsychological and clinical variables for 61 SLE patients and 61 healthy controls.</p