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Publications (10 of 27) Show all publications
Söderquist, F., Sundberg, I., Ramklint, M., Widerström, R., Hellström, P. M. & Cunningham, J. (2018). Daytime Salivary Melatonin Related to Gastrointestinal Symptoms in Young Adults Seeking Psychiatric Care. Paper presented at 73rd Annual Scientific Convention and Meeting of the Society-of-Biological-Psychiatry (SOBP), 2018, New York, NY. Biological Psychiatry, 83(9), S185-S186
Open this publication in new window or tab >>Daytime Salivary Melatonin Related to Gastrointestinal Symptoms in Young Adults Seeking Psychiatric Care
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2018 (English)In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 83, no 9, p. S185-S186Article in journal, Meeting abstract (Other academic) Published
Keywords
Melatonin, Irritable Bowel Syndrome, Depression
National Category
Psychiatry Gastroenterology and Hepatology
Identifiers
urn:nbn:se:uu:diva-361431 (URN)000432466300462 ()
Conference
73rd Annual Scientific Convention and Meeting of the Society-of-Biological-Psychiatry (SOBP), 2018, New York, NY
Available from: 2018-12-10 Created: 2018-12-10 Last updated: 2018-12-12Bibliographically approved
Sundberg, I., Lannergård, A., Ramklint, M. & Cunningham, J. L. (2018). Direct-acting antiviral treatment in real world patients with hepatitis C not associated with psychiatric side effects: a prospective observational study. BMC Psychiatry, 18, Article ID 157.
Open this publication in new window or tab >>Direct-acting antiviral treatment in real world patients with hepatitis C not associated with psychiatric side effects: a prospective observational study
2018 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 18, article id 157Article in journal (Refereed) Published
Abstract [en]

Background: Treatment of Hepatitis C virus (HCV) infection has evolved from interferon (IFN)-based treatments to direct-acting antivirals (DAAs). Patients with HCV have an elevated psychiatric morbidity (including substance abuse) and patients with such comorbidity have often been excluded from treatment with IFN. To date, little is known about psychiatric adverse effects of DAA-based regimens. We therefore aimed to study the psychiatric side effects of new IFN-free treatment for HCV (including depressive symptoms and sleep) in real world patients also including those with a history of psychiatric diagnosis, substance abuse or drug dependence. Methods: Consecutive patients were monitored during treatment with three of the latest DAA agents (sofosbuvir, simeprevir and daclatasvir). Repeated expert psychiatric assessments from baseline to 12 weeks post-treatment were performed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) clinical version and the self-report versions of the Montgomery Asberg Depression Rating Scale (MADRS-S) and the Pittsburgh Sleep Quality Index (PSQI). Friedman's test was performed to calculate differences in the MADRS-S and PSQI over time. In a post-hoc analysis Wilcoxon's test was used to compare baseline depressive symptoms with those at post-treatment. Spearman's rank correlation test was conducted in another post-hoc analysis to evaluate the correlation between symptoms of depression and HCV viral load at baseline. Results: At baseline, 15/17 patients (88%) had a history of any psychiatric diagnosis; 11 (65%) had a history of substance abuse or dependence; and 11 (65%) had previously been treated with IFN and six of those had experienced psychiatric side effects. There was no correlation between depressive symptoms and HCV viral load at baseline. Symptoms of depression did not increase during DAA treatment and were lower 12 weeks post-treatment compared with baseline: MADRS-S 10.7 vs. 8.3 (p = 0.01). This observation held when excluding patients taking antidepressant medication. Sleep quality did not significantly change during treatment. Adherence to treatment was estimated to 95% and sustained virological response was 88%. Conclusions: Despite high psychiatric morbidity, including previous substance abuse, patients successfully completed DAA treatment without increasing depressive symptoms or sleep disturbance. Symptoms of depression were significantly reduced 12 weeks after DAA treatment.

Keywords
Hepatitis C virus, Direct-acting antiviral, Depression, Sleep, Side effects
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-357557 (URN)10.1186/s12888-018-1735-6 (DOI)000433388700005 ()29843679 (PubMedID)
Funder
Swedish Society of MedicineFredrik och Ingrid Thurings StiftelseErik, Karin och Gösta Selanders Foundation
Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2018-12-12Bibliographically approved
Bränn, E., Fransson, E., White, R. A., Papadopoulos, F. C., Edvinsson, Å., Kamali-Moghaddam, M., . . . Skalkidou, A. (2018). Inflammatory markers in women with postpartum depressive symptoms. Journal of Neuroscience Research
Open this publication in new window or tab >>Inflammatory markers in women with postpartum depressive symptoms
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2018 (English)In: Journal of Neuroscience Research, ISSN 0360-4012, E-ISSN 1097-4547Article in journal (Refereed) Epub ahead of print
Abstract [en]

Postpartum depression (PPD) is a devastating disorder affecting not only more than 10% of all women giving birth, but also the baby, the family, and the society. Compiling evidence suggests the involvement of the immune system in the pathophysiology of major depression; yet, the immune response in perinatal depression is not as well studied. The aim of this study was to investigate the alterations in peripheral levels of inflammatory biomarkers in 169 Swedish women with and without depressive symptoms according to the Edinburgh postnatal depression scale or the M.I.N.I neuropsychiatric interview at eight weeks postpartum. Among the 70 markers analyzed with multiplex proximity extension assay, five were significantly elevated in women with postpartum depressive symptoms in the adjusted LASSO logistic regression analysis: Tumor necrosis factor ligand superfamily member (TRANCE) (OR-per 1 SD increase = 1.20), Hepatocyte growth factor (HGF) (OR = 1.17) Interleukin (IL)-18 (OR = 1.06), Fibroblast growth factor 23 (FGF-23) (OR = 1.25), and C-X-C motif chemokine 1 (CXCL1) (OR 1.11). These results indicate that women with PPD have elevated levels of some inflammatory biomarkers. It is, therefore, plausible that PPD is associated with a compromised adaptability of the immune system.

Keywords
cytokines, immune system, inflammation, maternal depression, pregnancy, protein markers
National Category
Psychiatry Immunology in the medical area Psychology
Identifiers
urn:nbn:se:uu:diva-362471 (URN)10.1002/jnr.24312 (DOI)30252150 (PubMedID)
Funder
Swedish Research Council, 521-2013-2339Swedish Research Council, 523-2014-2342Marianne and Marcus Wallenberg Foundation, 2011-Skalkidou
Available from: 2018-10-05 Created: 2018-10-05 Last updated: 2018-12-10Bibliographically approved
Just, D., Manberg, A., Lindholm Carlström, E., Cunningham, J. & Nilsson, P. (2018). TOWARDS MOLECULAR INSIGHTS INTO PSYCHIATRIC DISORDERS USING AFFINITY PROTEOMICS. Paper presented at 6th Biennial Conference of the Schizophrenia-International-Research-Society (SIRS), APR 04-08, 2018, Florence, ITALY. Schizophrenia Bulletin, 44, S223-S223
Open this publication in new window or tab >>TOWARDS MOLECULAR INSIGHTS INTO PSYCHIATRIC DISORDERS USING AFFINITY PROTEOMICS
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2018 (English)In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 44, p. S223-S223Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2018
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-357174 (URN)000429541800539 ()
Conference
6th Biennial Conference of the Schizophrenia-International-Research-Society (SIRS), APR 04-08, 2018, Florence, ITALY
Available from: 2018-08-14 Created: 2018-08-14 Last updated: 2018-08-14Bibliographically approved
Pisanu, C., Preisig, M., Castelao, E., Glaus, J., Cunningham, J. L., Del Zompo, M., . . . Mwinyi, J. (2017). High leptin levels are associated with migraine with aura. Cephalalgia, 37(5), 435-441
Open this publication in new window or tab >>High leptin levels are associated with migraine with aura
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2017 (English)In: Cephalalgia, ISSN 0333-1024, E-ISSN 1468-2982, Vol. 37, no 5, p. 435-441Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Migraine is a prevalent disorder characterised by recurrent headache attacks preceded or accompanied by aura in a subgroup of patients. Migraine often occurs together with major depressive disorder (MDD). Alterations of adipokine levels have been reported both in migraine and in MDD. In this cross-sectional study, we aimed to assess the associations between serum leptin and adiponectin levels and migraine or migraine subtypes. Analyses were adjusted for a lifetime history of MDD in order to investigate the association between adipokines and migraine under consideration of depression status.

METHODS: We included 3025 participants from the CoLaus/PsyCoLaus study. The impact of leptin and adiponectin levels on a diagnosis of migraine was analysed by binary regression analyses, adjusting for variables known to influence adipokine levels. Subgroup analyses were conducted based on the presence of aura.

RESULTS: Crude leptin levels were significantly higher in subjects with migraine than controls (Mann-Whitney U = 515,102, p = 6 × 10(-7)). When performing adjusted analyses, leptin levels were found to be significantly higher in subjects with migraine (odds ratio = 1.22, p = 0.024) and migraine with aura (odds ratio = 1.34, p = 0.004).

CONCLUSION: High leptin levels might play a role in the pathogenesis of migraine and migraine with aura.

Keywords
Migraine, adiponectin, aura, leptin, major depressive disorder
National Category
Neurosciences
Identifiers
urn:nbn:se:uu:diva-318574 (URN)10.1177/0333102416648650 (DOI)000399921200004 ()27165492 (PubMedID)
Funder
Swedish Society for Medical Research (SSMF)Swedish Research CouncilGlaxoSmithKline (GSK)NIH (National Institute of Health), MHOO2932
Available from: 2017-03-26 Created: 2017-03-26 Last updated: 2018-12-10Bibliographically approved
Sundberg, I., Lannergård, A., Ramklint, M. & Cunningham, J. (2017). Inflammatory Cytokines in a Repeated Measures Prospective Case Study of Interferon-Induced Depression. Paper presented at 72nd Annual Scientific Convention and Meeting of the Society-of-Biological-Psychiatry (SOBP), MAY 18-20, 2017, San Diego, CA. Biological Psychiatry, 81(10), S399-S399
Open this publication in new window or tab >>Inflammatory Cytokines in a Repeated Measures Prospective Case Study of Interferon-Induced Depression
2017 (English)In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 81, no 10, p. S399-S399Article in journal, Meeting abstract (Other academic) Published
Keywords
Interferon-induced depression, Depression, Melatonin, Cytokines and Chemokines, Hepatitis C
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-331809 (URN)10.1016/j.biopsych.2017.02.713 (DOI)000400348701079 ()
Conference
72nd Annual Scientific Convention and Meeting of the Society-of-Biological-Psychiatry (SOBP), MAY 18-20, 2017, San Diego, CA
Available from: 2017-10-18 Created: 2017-10-18 Last updated: 2017-10-18Bibliographically approved
Edvinsson, Å., Bränn, E., Hellgren, C., Freyhult, E., White, R., Kamali-Moghaddam, M., . . . Sundström Poromaa, I. (2017). Lower inflammatory markers in women with antenatal depression brings the M1/M2 balance into focus from a new direction. Psychoneuroendocrinology, 80, 15-25
Open this publication in new window or tab >>Lower inflammatory markers in women with antenatal depression brings the M1/M2 balance into focus from a new direction
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2017 (English)In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 80, p. 15-25Article in journal (Refereed) Published
Abstract [en]

Background: Antenatal depression and use of serotonin reuptake inhibitors (SSRI) in pregnancy have both been associated with an increased risk of poor pregnancy outcomes, such as preterm birth and impaired fetal growth. While the underlying biological pathways for these complications are poorly understood, it has been hypothesized that inflammation may be a common physiological pathway. The aim of the present study was to assess peripheral inflammatory markers in healthy women, women with antenatal depression, and in women using SSRI during pregnancy.

Methods: 160 healthy pregnant controls, 59 women with antenatal depression and 39 women on treatment with SSRIs were included. The relative levels of 92 inflammatory proteins were analyzed by proximity extension assay technology.

Results: Overall, 23 of the inflammatory markers were significantly lower in women with antenatal depression and in women on treatment with SSRIs in comparison with the healthy controls. No difference in any of the inflammatory markers was observed between women with antenatal depression and those who were using SSRI. Top three inflammatory markers that were down-regulated in women with antenatal depression were TNF-related apoptosis-inducing ligand (TRAIL), p = 0.000001, macrophage colony-stimulating factor 1 (CSF-1), p = 0.000004, and fractalkine (CX3CL1), p =0.000005. Corresponding inflammatory markers in SSRI users were CSF-1, p = 0.000011, vascular endothelial growth factor A (VEGF-A), p =0.000016, and IL-15 receptor subunit alpha (IL-15RA), p = 0.000027. The inflammatory markers were negatively correlated with cortisone serum concentrations in controls, but not in the cases. Differential DNA methylation of was found for seven of these inflammatory markers in an independent epigenetics cohort.

Conclusion: Women with antenatal depression or on SSRI treatment have lower levels of a number of peripheral inflammatory markers than healthy pregnant controls. Hypothetically, this could be due to dysregulated switch to the pro-M2 milieu that characterizes normal third trimester pregnancy. However, longitudinal blood sampling is needed to elucidate whether the presumably dysregulated M2 shift is driving the development of antenatal depression or is a result of the depression.

Place, publisher, year, edition, pages
PERGAMON-ELSEVIER SCIENCE LTD, 2017
Keywords
Antenatal depression, Pregnancy, Inflammatory markers, Proximity extension assay, Selective serotonin reuptake inhibitors
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-326211 (URN)10.1016/j.psyneuen.2017.02.027 (DOI)000402352200003 ()28292683 (PubMedID)
Available from: 2017-08-08 Created: 2017-08-08 Last updated: 2018-12-05
Cunningham, J. L., Zanzi, M., Willebrand, M., Ekselius, L. & Ramklint, M. (2017). No regrets: Young adult patients in psychiatry report positive reactions to biobank participation. BMC Psychiatry, 17, Article ID 21.
Open this publication in new window or tab >>No regrets: Young adult patients in psychiatry report positive reactions to biobank participation
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2017 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 17, article id 21Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Research in vulnerable individuals must insure voluntariness and minimize negative reactions caused by participation. This study aimed to describe consent and completion rate in young psychiatric patients in relation to study components, degree of disability and to compare response to research participation in patients and controls.

METHODS: Between 2012 and 2015, 463 patients with psychiatric disorders between the ages of 18-25 from the Dept. of General Psychiatry at Uppsala University Hospital and 105 controls were recruited to donate data and samples to a biobank. Consent and completion in relation to questionnaires, biological sampling of blood, saliva or feces, were monitored. Both groups were also asked about their perceived disability and how research participation affected them.

RESULTS: Most patients who participated consented to and completed questionnaires and blood sampling. The majority also consented to saliva sampling, while less than half consented to collect feces. Of those who gave consent to saliva and feces only half completed the sampling. Both patients and controls reported high voluntariness and were positive to research participation. Within the patient group, those with greater perceived disability reported greater distress while participating in research, but there was no difference in consent or completion rates or level of regret.

CONCLUSIONS: With the described information procedures, psychiatric patients, regardless of perceived disability, reported high voluntariness and did not regret participation in biobanking. Compared to questionnaires and blood sampling, given consent was reduced for feces and completion was lower for both saliva and feces sampling.

Keywords
Biobanking, Disability, Ethics, General psychiatry, Voluntariness
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-318531 (URN)10.1186/s12888-017-1199-0 (DOI)000394384300003 ()28095825 (PubMedID)
Funder
Swedish Society of Medicine
Note

Correction in BMC Psychiatry, Vol. 17 Article number 74. DOI: 10.1186/s12888-017-1228-z

Available from: 2017-03-25 Created: 2017-03-25 Last updated: 2018-12-10Bibliographically approved
Syk, M., Ramklint, M., Fredriksson, R., Ekselius, L. & Cunningham, J. L. (2016). Elevated total plasma-adiponectin is stable over time in young women with bulimia nervosa. European psychiatry, 41, 30-36, Article ID S0924-9338(16)30152-3.
Open this publication in new window or tab >>Elevated total plasma-adiponectin is stable over time in young women with bulimia nervosa
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2016 (English)In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 41, p. 30-36, article id S0924-9338(16)30152-3Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Bulimia nervosa (BN) is characterized by dysregulated eating behaviour and present data suggest adipokines may regulate food intake. We investigated a possible association between BN and adipokine levels and hypothesized that plasma (P)-adiponectin would be elevated and P-leptin and P-leptin-adiponectin-ratio would be reduced in women with BN.

METHODS: The study was designed as a cross-sectional study with a longitudinal arm for patients with BN. Plasma-adiponectin and leptin was measured in 148 female patients seeking psychiatric ambulatory care and 45 female controls. Fifteen patients were diagnosed with BN and the remaining with other affective and anxiety disorders. P-adiponectin and P-leptin levels were compared between patients with BN, patients without BN and controls. At follow-up 1-2years later, adipokines were reassessed in patients with BN and the Eating Disorder Examination Questionnaire was used to assess symptom severity.

RESULTS: P-adiponectin was elevated in patients with BN at baseline and at follow-up when compared to patients without BN and controls (P<0.004 and <0.008 respectively). The difference remained significant after controlling for body mass index. P-adiponectin was correlated to symptom severity at follow-up in patients with BN without morbid obesity (ρ=0.72, P<0.04). P-leptin-adiponectin-ratio was significantly lower in patients with BN compared to controls (P<0.04) and P-leptin non-significantly lower.

CONCLUSIONS: Findings indicate a stable elevation of P-adiponectin in women with BN. P-adiponectin at follow-up correlates to eating disorder symptom severity in patients without morbid obesity, indicating that P-adiponectin should be further investigated as a possible potential prognostic biomarker for BN.

Keywords
Adiponectin, Biomarker, Bulimia nervosa, Leptin, Prognosis
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-318532 (URN)10.1016/j.eurpsy.2016.09.006 (DOI)000397668400006 ()28049078 (PubMedID)
Funder
Swedish Society of Medicine
Available from: 2017-03-25 Created: 2017-03-25 Last updated: 2017-04-19Bibliographically approved
Söderquist, F., Tiensuu Janson, E., Rasmusson, A., Alit, A., Stridsberg, M. & Cunningham, J. L. (2016). Melatonin Immunoreactivity in Malignant Small Intestinal Neuroendocrine Tumours. PLoS ONE, 11(10), Article ID e0164354.
Open this publication in new window or tab >>Melatonin Immunoreactivity in Malignant Small Intestinal Neuroendocrine Tumours
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2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 10, article id e0164354Article in journal (Refereed) Published
Abstract [en]

Background/ Aims Small intestinal neuroendocrine tumours (SI-NETs) are derived from enterochromaffin cells. After demonstrating melatonin in enterochromaffin cells, we hypothesized that SI-NETs may express and secrete melatonin, which may have an impact on clinical factors and treatment response. Methods Tumour tissue from 26 patients with SI-NETs, representing paired sections of primary tumour and metastasis, were immunohistochemically stained for melatonin and its receptors, MT1 and MT2. Plasma melatonin and immunoreactivity (IR) for melatonin, MT1 and MT2 in tumour cells were compared to other tumour markers and clinical parameters. Melatonin was measured at two time points in fasting morning plasma from 43 patients with SI-NETs. Results Melatonin IR was found in all SI-NETS. Melatonin IR intensity in primary tumours correlated inversely to proliferation index (p = 0.022) and patients reported less diarrhoea when melatonin IR was high (p = 0.012). MT1 IR was low or absent in tumours. MT2 expression was medium to high in primary tumours and generally reduced in metastases (p = 0.007). Plasma-melatonin ranged from 4.5 to 220.0 pg/L. Higher levels were associated with nausea at both time points (p = 0.027 and p = 0.006) and flush at the second sampling. In cases with disease stabilization or remission (n = 34), circulating melatonin levels were reduced in the second sample (p = 0.038). Conclusion Immunoreactive melatonin is present in SI-NETs. Circulating levels of melatonin in patients with SI-NETs are reduced after treatment. Our results are congruent with recent understanding of melatonin's endocrine and paracrine functions and SI-NETs may provide a model for further studies of melatonin function.

National Category
Cancer and Oncology Neurology
Identifiers
urn:nbn:se:uu:diva-310013 (URN)10.1371/journal.pone.0164354 (DOI)000385505800057 ()27736994 (PubMedID)
Funder
Swedish Society of MedicineSwedish Cancer Society
Available from: 2016-12-12 Created: 2016-12-09 Last updated: 2018-12-10Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7876-7779

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