Establishing the bidirectional relationship between depression and subclinical arteriosclerosis – rationale, design, and characteristics of the BiDirect Study

BMC Psychiatry

Klaus Berger¹  Hans-Werner Hense¹  Jürgen Wellmann¹  Bernhard T Baune²  Walter Heindel³  Volker Arolt⁴  Maren Nagel¹  Heike Wersching¹  Henning Teismann¹ 

[1] Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany;Discipline of Psychiatry, University of Adelaide, Adelaide, Australia;Department for Clinical Radiology, University of Münster, Münster, Germany;Department for Psychiatry and Psychotherapy, University of Münster, Münster, Germany

关键词: Bidirectional;    Prospective cohort study;    White matter hyperintensities;    (f)MRI;    Cerebrovascular;    Cardiovascular;    Arteriosclerosis;    Depression subtypes;    Depression;   

Others  :  1123512
DOI  :  10.1186/1471-244X-14-174

 received in 2014-05-25, accepted in 2014-06-02,  发布年份 2014

【 摘 要 】

Background

Depression and cardiovascular diseases due to arteriosclerosis are both frequent and impairing conditions. Depression and (subclinical) arteriosclerosis appear to be related in a bidirectional way, and it is plausible to assume a partly joint causal relationship. However, the biological mechanisms and the behavioral pathways that lead from depression to arteriosclerosis and vice versa remain to be exactly determined.

Methods/design

This study protocol describes the rationale and design of the prospective BiDirect Study that aims at investigating the mutual relationship between depression and (subclinical) arteriosclerosis. BiDirect is scheduled to follow-up three distinct cohorts of individuals ((i) patients with acute depression (N = 999), (ii) patients after an acute cardiac event (N = 347), and (iii) reference subjects from the general population (N = 912)). Over the course of 12 years, four personal examinations are planned to be conducted. The core examination program, which will remain identical across follow-ups, comprises a personal interview (e.g. medical diagnoses, health care utilization, lifestyle and risk behavior), a battery of self-administered questionnaires (e.g. depressive symptoms, readiness to change health behavior, perceived health-related quality of life), sensory (e.g. olfaction, pain) and neuropsychological (e.g. memory, executive functions, emotional processing, manual dexterity) assessments, anthropometry, body impedance measurement, a clinical work-up regarding the vascular status (e.g. electrocardiogram, blood pressure, intima media thickness), the taking of blood samples (serum and plasma, DNA), and structural and functional resonance imaging of the brain (e.g. diffusion tensor imaging, resting-state, emotional faces processing). The present report includes BiDirect-Baseline, the first data collection wave.

Discussion

Due to its prospective character, the integration of three distinct cohorts, the long follow-up time window, the diligent diagnosis of depression taking depression subtypes into account, the consideration of relevant comorbidities and risk factors, the assessment of indicators of (subclinical) arteriosclerosis in different vascular territories, and the structural and functional brain imaging that is performed for a large number of participants, the BiDirect Study represents an innovative approach that combines population-based cohorts with sophisticated clinical work-up methods and that holds the potential to overcome many of the drawbacks characterizing earlier investigations.

【 授权许可】

   
2014 Teismann et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Hare DL, Toukhsati SR, Johansson P, Jaarsma T: Depression and cardiovascular disease: a clinical review. Eur Heart J 2014, 35(21):1365-1372.
• [2]Mathers C, Fat D, Boerma J: The Global Burden of Disease: 2004 Update. Geneva: World Health Organization; 2008.
• [3]Baumeister H, Parker G: Meta-review of depressive subtyping models. J Affect Disord 2012, 139:126-140.
• [4]Baune BT, Stuart M, Gilmour A, Wersching H, Arolt V, Berger K: Moderators of the relationship between depression and cardiovascular disorders: a systematic review. Gen Hosp Psychiatry 2012, 34:478-492.
• [5]Libby P, Ridker PM, Hansson GK: Progress and challenges in translating the biology of atherosclerosis. Nature 2011, 473:317-325.
• [6]Burnett JR: Lipids, lipoproteins, atherosclerosis and cardiovascular disease. Clin Biochem Rev 2004, 25:2.
• [7]Herrmann LL, Le Masurier M, Ebmeier KP: White matter hyperintensities in late life depression: a systematic review. J Neurol Neurosurg Psychiatry 2008, 79:619-624.
• [8]Davidson KW, Rieckmann N, Rapp MA: Definitions and distinctions among depressive syndromes and symptoms: implications for a better understanding of the depression-cardiovascular disease association. Psychosom Med 2005, 67(Suppl 1):S6-S9.
• [9]Barefoot JC, Schroll M: Symptoms of depression, acute myocardial infarction, and total mortality in a community sample. Circulation 1996, 93:1976-1980.
• [10]Nicholson A, Kuper H, Hemingway H: Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies. Eur Heart J 2006, 27:2763-2774.
• [11]Carney RM, Freedland KE: Depression, mortality, and medical morbidity in patients with coronary heart disease. Biol Psychiatry 2003, 54:241-247.
• [12]Baune BT, Stuart M, Gilmour A, Wersching H, Heindel W, Arolt V, Berger K: The relationship between subtypes of depression and cardiovascular disease: a systematic review of biological models. Transl Psychiatry 2012, 2:e92.
• [13]Ye S, Muntner P, Shimbo D, Judd SE, Richman J, Davidson KW, Safford MM: Behavioral mechanisms, elevated depressive symptoms, and the risk for myocardial infarction or death in individuals with coronary heart disease: the REGARDS (Reason for Geographic and Racial Differences in Stroke) study. J Am Coll Cardiol 2013, 61:622-630.
• [14]Win S, Parakh K, Eze-Nliam CM, Gottdiener JS, Kop WJ, Ziegelstein RC: Depressive symptoms, physical inactivity and risk of cardiovascular mortality in older adults: the cardiovascular health study. Heart 2011, 97:500-505.
• [15]Blumenthal JA: Targeting lifestyle change in patients with depression. J Am Coll Cardiol 2013, 61:631-634.
• [16]Elderon L, Whooley MA: Depression and cardiovascular disease. Prog Cardiovasc Dis 2013, 55:511-523.
• [17]Gasse C, Laursen TM, Baune BT: Major depression and first-time hospitalization with ischemic heart disease, cardiac procedures and mortality in the general population: a retrospective Danish population-based cohort study. Eur J Prev Cardiol 2014, 21(5):532-540.
• [18]Wersching H, Berger K: New cohorts. The BiDirect study. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012, 55:822-823.
• [19]Ackenheil M, Stotz-Ingenlath G, Dietz-Bauer R, Vossen A: M.I.N.I. Mini International Neuropsychiatric Interview (German version 5.0.0, DSM-IV). Munich: Psychiatric University Clinic; 1999.
• [20]Rush A, Giles D, Schlesser M: The inventory for depressive symptomatology (IDS): preliminary findings. Psychiatry Res 1986, 18:65-87.
• [21]Hamilton M: A rating scale for depression. J Neurol Neurosurg Psychiatry 1960, 23:56-62.
• [22]Hamilton M: The assessment of anxiety states by rating. Br J Med Psychol 1959, 32:50-55.
• [23]Wellmann J, Heidrich J, Berger K, Döring A, Heuschmann PU, Keil U: Changes in alcohol intake and risk of coronary heart disease and all-cause mortality in the MONICA/KORA-Augsburg cohort 1987–97. Eur J Cardiovasc Prev Rehabil 2004, 11:48-55.
• [24]Berger K: DHS: the Dortmund health study. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012, 55:816-821.
• [25]Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ: The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 1989, 28:193-213.
• [26]Radloff LS: The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977, 1:385-401.
• [27]Pfaffenrath V, Fendrich K, Vennemann M, Meisinger C, Ladwig K-H, Evers S, Straube A, Hoffmann W, Berger K: Regional variations in the prevalence of migraine and tension-type headache applying the new IHS criteria: the German DMKG Headache Study. Cephalalgia 2009, 29:48-57.
• [28]Ruscheweyh R, Verneuer B, Dany K, Marziniak M, Wolowski A, Colak-Ekici R, Schulte TL, Bullmann V, Grewe S, Gralow I, Evers S, Knecht S: Validation of the pain sensitivity questionnaire in chronic pain patients. Pain 2012, 153:1210-1218.
• [29]Grabe HJ, Schulz A, Schmidt CO, Appel K, Driessen M, Wingenfeld K: Childhood Trauma Screener (CTS) - a brief instrument for the assessment of childhood abuse and neglect. Psychiatr Prax 2012, 39:109-115.
• [30]Prochaska J, Velicer W: The transtheoretical model of health behavior change. Am J Heal Promot 1997, 12:38-48.
• [31]Rabin R, De Charro F: EQ-5D: a measure of health status from the EuroQol group. Ann Med 2001, 33:337-343.
• [32]Kissler J, Assadollahi R, Herbert C: Emotional and semantic networks in visual word processing: insights from ERP studies. Prog Brain Res 2006, 156:147-183.
• [33]Aschenbrenner S, Tucha O, Lange K: Regensburger Wortflüssigkeits-Test. Göttingen Bonn Toronto Seattle: Hogrefe; 2000.
• [34]Oswald W, Fleischmann U: Nürnberger-Alters-Inventar. Göttingen Bonn Toronto Seattle: Hogrefe; 1997.
• [35]Reitan R: Validity of the trail making test as an indicator of organic brain damage. Percept Mot Skills 1958, 8:271-276.
• [36]Tiffin J, Asher E: The Purdue pegboard: norms and studies of reliability and validity. J Appl Psychol 1948, 32:234-247.
• [37]Dannlowski U, Ohrmann P, Konrad C, Domschke K, Bauer J, Kugel H, Hohoff C, Schöning S, Kersting A, Baune BT, Mortensen LS, Arolt V, Zwitserlood P, Deckert J, Heindel W, Suslow T: Reduced amygdala-prefrontal coupling in major depression: association with MAOA genotype and illness severity. Int J Neuropsychopharmacol 2009, 12:11-22.
• [38]Debette S, Markus H: The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 2010, 341:c3666.
• [39]Kuller LH, Arnold AM, Longstreth WT, Manolio TA, O’Leary DH, Burke GL, Fried LP, Newman AB: White matter grade and ventricular volume on brain MRI as markers of longevity in the cardiovascular health study. Neurobiol Aging 2007, 28:1307-1315.
• [40]Sachdev PS, Parslow R, Wen W, Anstey KJ, Easteal S: Sex differences in the causes and consequences of white matter hyperintensities. Neurobiol Aging 2009, 30:946-956.
• [41]Sundermann B, Herr D, Schwindt W, Pfleiderer B: Multivariate classification of blood oxygen level-dependent fMRI data with diagnostic intention: a clinical perspective. AJNR Am J Neuroradiol 2014, 35(5):848-855.