Alexithymia, Suicide Ideation and Homocysteine Levels in Drug Naïve Patients with Major Depression: A Study in the Real World Clinical Practice

Berardis, Domenico De; Olivieri, Luigi; Rapini, Gabriella; Natale, Serena Di; Serroni, Nicola; Fornaro, Michele; Orsolini, Laura; Valchera, Alessandro; Carano, Alessandro; Vellante, Federica; Varasano, Paola Annunziata; Pressanti, Gabriella Lucidi; Serafini, Gianluca; Pompili, Maurizio; Martinotti, Giovanni; Giannantonio, Massimo Di

doi:10.9758/cpn.2019.17.2.318

Cited by 32 publications

(21 citation statements)

References 31 publications

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“…In addition, it should be noted that our review focused only on a limited set of variables, while other individual/clinical factors, relatively easy to assess in clinical practice, may play a role, such as childhood maltreatment/adversities, [124][125][126] inflammatory markers, 127,128 other symptom profiles or individual features. Among the latter, alexithymia, reflecting difficulty with identifying and expressing emotions, seems to be associated with higher severity of depression, increased suicide risk, and pro-inflammatory imbalance; [129][130][131][132][133] thus its potential contribute to selection of specific antidepressant class/compound may be worth investigating. Finally, we did not include combined pharmacotherapies, augmentation strategies, or non-pharmacological interventions.…”

Section: Discussionmentioning

confidence: 99%

Personalized Psychiatry and Depression: The Role of Sociodemographic and Clinical Variables

Perna

Alciati²,

Daccò

et al. 2020

Psychiatry Investig

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Despite several pharmacological options, the clinical outcomes of major depressive disorder (MDD) are often unsatisfactory. Personalized psychiatry attempts to tailor therapeutic interventions according to each patient’s unique profile and characteristics. This approach can be a crucial strategy in improving pharmacological outcomes in MDD and overcoming trial-and-error treatment choices. In this narrative review, we evaluate whether sociodemographic (i.e., gender, age, race/ethnicity, and socioeconomic status) and clinical [i.e., body mass index (BMI), severity of depressive symptoms, and symptom profiles] variables that are easily assessable in clinical practice may help clinicians to optimize the selection of antidepressant treatment for each patient with MDD at the early stages of the disorder. We found that several variables were associated with poorer outcomes for all antidepressants. However, only preliminary associations were found between some clinical variables (i.e., BMI, anhedonia, and MDD with melancholic/atypical features) and possible benefits with some specific antidepressants. Finally, in clinical practice, the assessment of sociodemographic and clinical variables considered in our review can be valuable for early identification of depressed individuals at high risk for poor responses to antidepressants, but there are not enough data on which to ground any reliable selection of specific antidepressant class or compounds. Recent advances in computational resources, such as machine learning techniques, which are able to integrate multiple potential predictors, such as individual/ clinical variables, biomarkers, and genetic factors, may offer future reliable tools to guide personalized antidepressant choice for each patient with MDD.

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Section: Discussionmentioning

confidence: 99%

Personalized Psychiatry and Depression: The Role of Sociodemographic and Clinical Variables

Perna

Alciati²,

Daccò

et al. 2020

Psychiatry Investig

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“…Another issue which should not be overlooked is that, notwithstanding patients' primary psychiatric diagnosis, increasing evidence suggests that alexithymia may play a role as risk factor for suicide, often mediated by depressive symptoms (37,38). Biological correlates of the relationship between alexithymia and suicidal behaviors have been suggested, including for instance homocysteine dysregulation (39). This evidence further supports the importance to screen for alexithymia in the everyday clinical practice with psychiatric patients, including those suffering from EDs (40).…”

Section: Introductionmentioning

confidence: 86%

Alexithymia and Treatment Outcome in Anorexia Nervosa: A Scoping Review of the Literature

2020

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Alexithymia is of great interest as an outcome predictor of recovery from anorexia nervosa, since it may interfere with both treatment compliance and patients' ability to benefit from the adopted interventions. For this reason, in the last years new treatment approaches targeting emotion identification, expression, and regulation have been applied and tested. Using the PRISMA methodology, we performed a scoping review of the literature about treatment outcome in anorexia nervosa, in terms of changes in alexithymia as assessed by its most commonly used self-report measure, the Toronto Alexithymia Scale (TAS). The Medline and Scopus databases were searched, and articles were included if matching the following criteria: dealing with patients affected by anorexia nervosa, without limits of age; involving the application of any kind of targeted therapy or treatment; assessing alexithymia and the effect of a treatment intervention on alexithymia, using the TAS. Ten studies were eventually included; overall, according to the selected studies, alexithymia levels often remain high even after specific treatment. Further research aimed at a deeper understanding of the actual impact of alexithymia on the outcome of anorexia, as well as exploring alternative treatment strategies for alexithymia in eating disorders (EDs), are warranted.

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“…145 Similarly, the alexithymia construct applied to MDD subjects, seemed to demonstrate a correlation between alexithymia traits, MDD severity and increased risk of SI and more severe SA. 146,147…”

Section: Temperament Character and Personality Traitsmentioning

confidence: 99%

Understanding the Complex of Suicide in Depression: from Research to Clinics

Orsolini

Latini²,

Pompili³

et al. 2020

Psychiatry Investig

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255

167

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Objective Amongst psychiatric disorders, major depressive disorder (MDD) is the most prevalent, by affecting approximately 15–17% of the population and showing a high suicide risk rate equivalent to around 15%. The present comprehensive overview aims at evaluating main research studies in the field of MDD at suicide risk, by proposing as well as a schematic suicide risk stratification and useful flow-chart for planning suicide preventive and therapeutic interventions for clinicians.Methods A broad and comprehensive overview has been here conducted by using PubMed/Medline, combining the search strategy of free text terms and exploded MESH headings for the topics of ‘Major Depressive Disorder’ and ‘Suicide’ as following: ((<i>suicide</i> [Title/Abstract]) AND (<i>major depressive disorder</i> [Title/Abstract])). All articles published in English through May 31, 2019 were summarized in a comprehensive way.Results Despite possible pathophysiological factors which may explain the complexity of suicide in MDD, scientific evidence supposed the synergic role of genetics, exogenous and endogenous stressors (i.e., interpersonal, professional, financial, as well as psychiatric disorders), epigenetic, the hypothalamic-pituitary-adrenal stress-response system, the involvement of the monoaminergic neurotransmitter systems, particularly the serotonergic ones, the lipid profile, neuro-immunological biomarkers, the Brain-derived neurotrophic factor and other neuromodulators.Conclusion The present overview reported that suicide is a highly complex and multifaceted phenomenon in which a large plethora of mechanisms could be variable implicated, particularly amongst MDD subjects. Beyond these consideration, modern psychiatry needs a better interpretation of suicide risk with a more careful assessment of suicide risk stratification and planning of clinical and treatment interventions.

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Alexithymia, Suicide Ideation and Homocysteine Levels in Drug Naïve Patients with Major Depression: A Study in the Real World Clinical Practice

Cited by 32 publications

References 31 publications

Personalized Psychiatry and Depression: The Role of Sociodemographic and Clinical Variables

Personalized Psychiatry and Depression: The Role of Sociodemographic and Clinical Variables

Alexithymia and Treatment Outcome in Anorexia Nervosa: A Scoping Review of the Literature

Understanding the Complex of Suicide in Depression: from Research to Clinics

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Alexithymia, Suicide Ideation and Homocysteine Levels in Drug Naïve Patients with Major Depression: A Study in the Real World Clinical Practice

Cited by 32 publications

References 31 publications

Personalized Psychiatry and Depression: The Role of Sociodemographic and Clinical Variables

Personalized Psychiatry and Depression: The Role of Sociodemographic and Clinical Variables

Alexithymia and Treatment Outcome in Anorexia Nervosa: A Scoping Review of the Literature

Understanding the Complex of Suicide in Depression: from Research to Clinics

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Product

Resources

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Alexithymia, Suicide Ideation and Homocysteine Levels in Drug Naïve Patients with Major Depression: A Study in the Real World Clinical Practice