Background: : Psychiatric disorders are associated with overweight/obesity. Obsessive-compulsive disorder(OCD) may be an exception, as anecdotal evidence suggests lower BMI in OCD. Additionally,... Show moreBackground: : Psychiatric disorders are associated with overweight/obesity. Obsessive-compulsive disorder(OCD) may be an exception, as anecdotal evidence suggests lower BMI in OCD. Additionally, depression isassociated with elevated BMI, but effects of comorbid secondary depression are unknown. The aim of the presentstudy was to assess BMI and risk for overweight/obesity in OCD and to assess the effect of comorbid depressionon BMI.Methods: : BMI, demographics, and clinical status were assessed in large samples of individuals with OCD,anxiety disorders, depressive disorders, comorbid anxiety/depressive disorders, and non-clinical controls (NCC).Results: : Although no initial differences were found between the samples on BMI, the non-depressed OCDsubsample had significantly lower BMI and risk for overweight/obesity compared to all other clinical samples.NCC were nearly twice as likely to be overweight compared to non-depressed OCD.Limitations: : Eating disorders were excluded in the OCD sample, but BMI < 17 was used as an exclusion cri-terion in the clinical control groups in lieu of screening for Anorexia. Group differences on demographics werecontrolled for. Recruitment methodology differed between samples.Conclusions: : OCD is associated with significantly lower rates of obesity and overweight, but this relationshipwas not found when comorbid depression was present. This suggests that the purer the phenotype of OCD, themore substantial protective factor against overweight/obesity emerges compared to other clinical samples andNCC. An OCD-specific reward/anhedonia model, previously offered to elucidate lower smoking rates in OCD,may account for lower BMI in OCD. These results warrant careful clinical attention to the negative impact ofcomorbid depression on OCD that spans from increasing risk for obesity and cigarette smoking, to hinderingtreatment response. Show less
Henstra, M.J.; Feenstra, T.C.; Velde, N. van der; Mast, R.C. van der; Comijs, H.; Stek, M.L.; Rhebergen, D. 2019
Background In older people, both apathy and depression (which frequently co-occurs with apathy) have been associated with poor physical functioning, a major health concern. We investigated the... Show moreBackground In older people, both apathy and depression (which frequently co-occurs with apathy) have been associated with poor physical functioning, a major health concern. We investigated the association between apathy and physical functioning in older people without dementia and whether this association is modified by depression.Methods We used the data from 380 older participants (with and without depression) taking part in the Netherlands Study of Depression in Older Persons, with baseline scores on the Apathy Scale and baseline and 2-year follow-up scores on at least one measure of physical functioning. These included the International Physical Activities Questionnaire (IPAQ, self-reported), WHO Disability Assessment Schedule (WHO-DASII mobility subset, self-reported), walking speed, or handgrip strength. Multivariable linear regression analyses were performed to examine the association between apathy at baseline and physical functioning at 2-year follow-up. We also investigated effect modification by sex, age, and depression.Results Cross-sectionally, participants with higher baseline Apathy Scale scores performed significantly worse on all measures of physical functioning. Longitudinally, higher baseline Apathy Scale scores were associated with higher delta scores on the IPAQ (B = -59.81) in the basic model, and higher delta scores on the WHO-DASII (B = .09) in all models. Apathy was not associated with higher delta scores for walking speed or handgrip strength. Furthermore, sex, age, and depression did not modify any association.Conclusion In a Dutch cohort of older people without dementia, apathy was associated with more decline in self-reported, but not in objective physical functioning. Sex, age, and depression did not modify these associations. In older people with apathy, subjective decline may precede decline in physical performance tests. Show less
Insufficient response to treatment is the main cause of prolonged suffering from major depressive disorder (MDD). Early identification of insufficient response could result in faster and more... Show moreInsufficient response to treatment is the main cause of prolonged suffering from major depressive disorder (MDD). Early identification of insufficient response could result in faster and more targeted treatment strategies to reduce suffering. We therefore explored whether baseline alterations within and between resting state functional connectivity networks could serve as markers of insufficient response to antidepressant treatment in two years of follow-up. We selected MDD patients (N = 17) from the NEtherlands Study of Depression and Anxiety (NESDA), who received >= two antidepressants, indicative for insufficient response, during the two year follow-up, a group of MDD patients who received only one antidepressant (N = 32) and a healthy control group (N = 19) matched on clinical characteristics and demographics. An independent component analysis (ICA) of baseline resting-state scans was conducted after which functional connectivity within the components was compared between groups. We observed lower connectivity of the right insula within the salience network in the group with >= two anti-depressants compared to the group with one antidepressant. No difference in connectivity was found between the patient groups and healthy control group. Given the suggested role of the right insula in switching between task-positive mode (activation during attention-demanding tasks) and task-negative mode (activation during the absence of any task), we explored whether right insula activation differed during switching between these two modes. We observed that in the 2 anti-depressant group, the right insula was less active compared to the group with one antidepressant, when switching from task-positive to task-negative mode than the other way around. These findings imply that lower right insula connectivity within the salience network may serve as an indicator for prospective insufficient response to antidepressants. This result, supplemented by the diminished insula activation when switching between task and rest related networks, could indicate an underlying mechanism that, if not sufficiently targeted by current antidepressants, could lead to insufficient response. When replicated, these findings may contribute to the identification of biomarkers for early detection of insufficient response. Show less
Loosman, W.L.; Haverkamp, G.L.G.; Beukel, T.O. van den; Hoekstra, T.; Dekker, F.W.; Shaw, P.K.C.; ... ; Honig, A. 2018
In een cross-sectioneel onderzoek is nagegaan hoe het op de lange duur met CVA patiënten gaat die in het Haaglanden Medisch Centrum te Den Haag opgenomen zijn geweest vanwege een beroerte. Er is... Show moreIn een cross-sectioneel onderzoek is nagegaan hoe het op de lange duur met CVA patiënten gaat die in het Haaglanden Medisch Centrum te Den Haag opgenomen zijn geweest vanwege een beroerte. Er is gekeken naar verschillende aspecten zoals handfunctie, werkhervatting, stemmingsproblemen en zorggebruik. Het blijkt dat, ondanks alle behandelingen die gegeven worden, een grote groep van deze mensen restbeperkingen ervaart. Hun partners voelen zich fors belast, vooral als er sprake is van stemmingsproblemen en als werkhervatting niet lukt. Ook jaren later geeft de meerderheid van CVA patiënten aan nog steeds zorgvragen te hebben die niet beantwoord zijn. Ze lijken beter hun weg te vinden in de eerstelijn voor hun fysieke problemen dan voor hun mentale problemen. Er is gekeken naar de mate waarin eerstelijns behandelaars zich hebben georganiseerd met betrekking tot chronische behandeling en begeleiding van CVA patiënten. Een goed georganiseerd netwerk, met een visie op kwaliteitsaspecten en scholing, is maar op enkele plaatsen in het land beschikbaar. Er zijn aanbevelingen geformuleerd om de ontwikkeling van eerstelijns netwerken voor CVA patiënten te stimuleren. Show less
Hoewel voorheen al onderzoek is verschenen naar verschillende onderdelen van de migrainedriehoek: chronificatie, depressie, en medicatieafhankelijkheid, waren er nog altijd ontbrekende stukken van... Show moreHoewel voorheen al onderzoek is verschenen naar verschillende onderdelen van de migrainedriehoek: chronificatie, depressie, en medicatieafhankelijkheid, waren er nog altijd ontbrekende stukken van de puzzel. Dit proefschrift onderzocht verschillende aspecten van deze driehoeksrelatie, waarbij wij ons richtten op:• klinische determinanten van depressie in migrainepatiënten (hoofdstuk 2 en 3),• de associatie van depressie met migraine aanvalsfrequentie, zowel in dwarsdoorsnede onderzoek (hoofdstuk 2) als in longitudinale studieopzet (hoofdstuk 3),• de rol van allodynie van de huid in zowel de comorbiditeit met depressie alsook migraine chronificatie (hoofdstuk 2 en 3),• symptoomdimensies van affectieve stoornissen in migrainepatiënten, in vergelijking met personen zonder migraine met en zonder affectieve aandoeningen (hoofdstuk 5),• de comorbiditeit van depressie in hemiplegische migraine, als een monogenetisch migraine fenotype (hoofdstuk 4),• genetische factoren die betrokken zijn bij migraine chronificatie (hoofdstuk 7),• de comorbiditeit van depressie in clusterhoofdpijn, als een ernstige episodische primaire hoofdpijnvorm anders dan migraine (hoofdstuk 8), en• de behandeling van medicatieafhankelijke hoofdpijn. Show less
Molendijk, M.; Molero, P.; Sanchez-Pedreno, F.O.; Does, W. van der; Martinez-Gonzalez, M.A. 2018
In this thesis, longitudinal analyses have been performed on the PROPARK-Cohort, a hospital-based cohort of 421 patients followed for a period of five years. The main focus of this thesis was... Show moreIn this thesis, longitudinal analyses have been performed on the PROPARK-Cohort, a hospital-based cohort of 421 patients followed for a period of five years. The main focus of this thesis was to determine which predictors and associated factors contributed to the development of certain non-motor symptoms in Parkinson’s disease (PD). Strengths of our cohort study include the length of the follow-up period, broad clinical characterization, limited loss-to-follow-up and the large cohort size. The following non-motor symptoms have been addressed in this thesis: psychosis (hallucinations), dementia, excessive daytime sleepiness (EDS), insomnia, depression and anxiety. We found that while certain non-motor symptoms are inherent components of PD that increase in severity as the disease progresses, others symptoms such as excessive daytime sleepiness are inarguably caused by antiparkinsonian medication. For the future, we hope to see more longitudinal data on the disease progression in PD from large cohorts. Knowledge from longitudinal studies does not only contribute to more insight in the underlying pathobiology of PD, but it could also help the caregiver to monitor patients with particular risk factors more closely and adjust treatment if necessary. Show less
