World Journal of Biological Psychiatry最新文献

{"title":"Peripheral signature of altered synaptic integrity in young onset cannabis use disorder: A proteomic study of circulating extracellular vesicles.","authors":"Suhas Ganesh, TuKiet T Lam, Rolando Garcia-Milian, Deepak Cyril D'Souza, Angus C Nairn, Katya Elgert, Erez Eitan, Mohini Ranganathan","doi":"10.1080/15622975.2023.2197039","DOIUrl":"10.1080/15622975.2023.2197039","url":null,"abstract":"<p><strong>Background: </strong>Rates of Cannabis Use Disorder (CUD) are highest amongst young adults. Paucity of brain tissue samples limits the ability to examine the molecular basis of cannabis related neuropathology. Proteomic studies of neuron-derived extracellular vesicles (NDEs) isolated from the biofluids may reveal markers of neuropathology in CUD.</p><p><strong>Methods: </strong>NDEs were extracted using ExoSORT, an immunoaffinity method to enrich NDEs from plasma samples from patients with young onset CUD and matched controls. Differential proteomic profiles were explored with Label Free Quantification (LFQ) mass spectrometry. Selected proteins were validated using orthogonal methods.</p><p><strong>Results: </strong>A total of 231 (±10) proteins were identified in NDE preparations from CUD and controls of which 28 were differentially abundant between groups. The difference in abundance of properdin (<i>CFP</i> gene) was statistically significant. SHANK1 (<i>SHANK1</i> gene), an adapter protein at the post-synaptic density, was nominally depleted in the CUD NDE preparations.</p><p><strong>Conclusion: </strong>In this pilot study, we noted a decrease in SHANK1 protein, involved in the structural and functional integrity of glutamatergic post-synapse, a potential peripheral signature of CUD neuropathology. The study shows that LFQ mass spectrometry proteomic analysis of NDEs derived from plasma may yield important insights into the synaptic pathology associated with CUD.</p>","PeriodicalId":49358,"journal":{"name":"World Journal of Biological Psychiatry","volume":"24 7","pages":"603-613"},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10144640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase-and disorder-specific differences in peripheral metabolites of the kynurenine pathway in major depression, bipolar affective disorder and schizophrenia.","authors":"Murielle Brum,&nbsp;Matthias Nieberler,&nbsp;Christopher Kehrwald,&nbsp;Katrin Knopf,&nbsp;Nathalie Brunkhorst-Kanaan,&nbsp;Semra Etyemez,&nbsp;Kelly A Allers,&nbsp;Robert A Bittner,&nbsp;David A Slattery,&nbsp;Rhiannon V McNeill,&nbsp;Andreas Reif,&nbsp;Sarah Kittel-Schneider","doi":"10.1080/15622975.2023.2169348","DOIUrl":"10.1080/15622975.2023.2169348","url":null,"abstract":"<p><strong>Objectives: </strong>Kynurenine, kynurenic and quinolinic acid are important metabolites in tryptophan metabolism. Due to an involvement in glutamatergic neurotransmission and immune response, previous studies have investigated this pathway in mental disorders such as major depressive disorder (MDD), bipolar disorder (BD) or schizophrenia (SCZ). Tryptophan and kynurenine have been shown to be decreased across disorders, hinting at the missing link how inflammation causes neurotoxicity and psychiatric symptoms. The main aim of our study was to investigate if individual catabolites could serve as diagnostic biomarkers for MDD, BD and SCZ.</p><p><strong>Methods: </strong>We measured plasma levels of tryptophan, kynurenine, kynurenic acid, quinolinic acid and ratio of quinolinic acid/kynurenic acid using mass spectrometry in <i>n</i> = 175 participants with acute episodes and after remission, compared with controls.</p><p><strong>Results: </strong>Decreased levels of all tryptophan catabolites were found in the whole patient group, driven by the difference between BD and HC. Manic and mixed phase BD individuals displayed significantly lower kynurenine and kynurenic acid levels. We could not find significant differences between disorders. Upon reaching remission, changes in catabolite levels partially normalised.</p><p><strong>Conclusions: </strong>Our data suggests an involvement of the kynurenine pathway in mental disorders, especially BD but disqualifying those metabolites as biomarkers for differential diagnosis.</p>","PeriodicalId":49358,"journal":{"name":"World Journal of Biological Psychiatry","volume":"24 7","pages":"564-577"},"PeriodicalIF":3.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9876937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoter methylation of the glucocorticoid receptor following trauma may be associated with subsequent development of PTSD.","authors":"Lior Carmi, Joseph Zohar, Alzbeta Juven-Wetzler, Frank Desarnaud, Louri Makotkine, Linda M Bierer, Hagit Cohen, Rachel Yehuda","doi":"10.1080/15622975.2023.2177342","DOIUrl":"10.1080/15622975.2023.2177342","url":null,"abstract":"<p><strong>Objectives: </strong>The ability to identify persons at elevated risk for post-traumatic stress disorder (PTSD) soon after exposure to trauma, could aid clinical decision-making and treatment. In this study, we explored whether cytosine methylation of the 1 F promoter of the <i>NR3C1</i> (glucocorticoid receptor [GR]) gene obtained immediately following a trauma could predict PTSD.</p><p><strong>Methods: </strong>Our sample comprised 52 trauma survivors (28 women, 24 men), presenting to the Emergency Department (ED) within six hours of a traumatic event and followed for 13 months. Blood samples were taken at intake (<i>n</i> = 42) and again at the end of the study (13 months later, <i>n</i> = 27) to determine <i>NR3C1-1F</i> promoter methylation as well as plasma levels of cortisol, adrenocorticotropic-hormone (ACTH), and neuropeptide-Y (NPY).</p><p><strong>Results: </strong>At the 13-month follow-up, participants who met the PTSD criteria (<i>n</i> = 4) showed significantly lower <i>NR3C1-1F</i> promoter sum percent methylation compared to the non-PTSD group (<i>n</i> = 38). Further, <i>NR3C1-1F</i> methylation at ED intake was inversely correlated with PTSD severity 13 months later, indicating that lower <i>NR3C1-1F</i> promoter methylation in the immediate aftermath of trauma was associated with the development of PTSD.</p><p><strong>Conclusion: </strong>To the extent that reduced promoter methylation is associated with greater GR expression and responsivity, this finding is consistent with the hypothalamic-pituitary-adrenal dysregulation previously described for PTSD.</p>","PeriodicalId":49358,"journal":{"name":"World Journal of Biological Psychiatry","volume":"24 7","pages":"578-586"},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10440098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10042432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of depression and borderline personality disorder with 1 Hz repetitive transcranial magnetic stimulation of the orbitofrontal cortex - A pilot study.","authors":"C Reinsberg,&nbsp;M Schecklmann,&nbsp;M A Abdelnaim,&nbsp;F C Weber,&nbsp;B Langguth,&nbsp;T Hebel","doi":"10.1080/15622975.2023.2186484","DOIUrl":"10.1080/15622975.2023.2186484","url":null,"abstract":"<p><p>Borderline personality disorder (BPD) is characterised by impairments in emotional regulation, impulse control and interpersonal interaction. Comorbid depression is common. The orbitofrontal cortex (OFC) plays a crucial role in the biological substrate of BPD. We investigated the effects of 1 Hz repetitive transcranial magnetic stimulation (rTMS) targeting the OFC on depressive symptoms and symptoms of BPD in 15 patients suffering from both conditions to assess feasibility and effectiveness. Target treatment intensity was 120% of resting motor threshold (RMT) and intended duration four weeks. Treatment improved both symptoms of depression as measured by the Hamilton Depression Rating Scale and of BPD as measured by Borderline Symptom List-23 and Barratt Impulsivity Scale. Drop-out rates were high with 7/15 patients not completing the full course of rTMS, but only two drop-outs were related to treatment. Only a minority of patients tolerated target treatment intensity. Despite the limitations, the results suggest efficacy of treatment and welcome further research.</p>","PeriodicalId":49358,"journal":{"name":"World Journal of Biological Psychiatry","volume":"24 7","pages":"595-602"},"PeriodicalIF":3.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9880397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric onset of prodromal dementia with Lewy bodies: Current insights into neuroimaging tools.","authors":"Niels Hansen,&nbsp;Sebastian Johannes Müller,&nbsp;Eya Khadhraoui,&nbsp;Marielle Ernst,&nbsp;Christian Heiner Riedel,&nbsp;Jens Wiltfang,&nbsp;Claudia Lange,&nbsp;Carolin Bouter","doi":"10.1080/15622975.2023.2191008","DOIUrl":"10.1080/15622975.2023.2191008","url":null,"abstract":"<p><strong>Purpose: </strong>Our article is dedicated to describing the state-of-the-art in imaging techniques for assessing prodromal dementia with Lewy bodies (pro-DLB) with a psychiatric-onset.</p><p><strong>Materials and methods: </strong>Imaging biomarker techniques are discussed.</p><p><strong>Results: </strong>(123)-I-2-ß-carbomethoxy-3ß-(4-iodophenyl)-<i>N</i>-(3-fluoropropyl) nortropane single photon emission computed tomography (123I-FP-CIT SPECT) seems to be a promising method as it reveals abnormalities in pro-DLB with a psychiatric-onset. New potential biomarkers can be revealed <i>via</i> novel techniques, such as manual segmentation in magnetic resonance imaging (MRI), which helps detect atrophy of the substantia innominata in pro-DLB with a psychiatric-onset as opposed to an onset with mild cognitive impairment (MCI). FDG-PET can also help us distinguish patients with mixed pro-DLB from those pro-DLB patients with a psychiatric-onset or MCI-onset. Changes in large-scale networks in the posterior standard mode and in attentional networks could be early signs in resting-state functional MRI to characterise pro-DLB.</p><p><strong>Conclusions: </strong>In conclusion, there is a wide range of techniques that need to be explored in large-scale studies and are of promising value in understanding pro-DLB with a psychiatric-onset.</p>","PeriodicalId":49358,"journal":{"name":"World Journal of Biological Psychiatry","volume":"24 7","pages":"558-563"},"PeriodicalIF":3.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9880403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral ketamine for depression: An updated systematic review.","authors":"Shakila Meshkat,&nbsp;Sipan Haikazian,&nbsp;Joshua D Di Vincenzo,&nbsp;Farhan Fancy,&nbsp;Danica Johnson,&nbsp;David Chen-Li,&nbsp;Roger S McIntyre,&nbsp;Rodrigo Mansur,&nbsp;Joshua D Rosenblat","doi":"10.1080/15622975.2023.2169349","DOIUrl":"10.1080/15622975.2023.2169349","url":null,"abstract":"<p><p><b>Objectives:</b> Ketamine is a glutamate N-methyl-D-aspartate receptor antagonist that can be used to treat major depressive disorder by single or repeated infusions. However, the accessibility and scalability of oral ketamine make it preferred over intravenous ketamine. In this systematic review, we aim to evaluate the efficacy, tolerability, and safety of oral ketamine, esketamine and r-ketamine for unipolar and bipolar depression. <b>Materials and methods:</b> Electronic databases were searched from inception to September 2022 to identify relevant articles. <b>Results:</b> Twenty-two studies, including four randomized clinical trials (RCTs), one case series, six case reports, five open-label trials and six retrospective chart review studies involving 2336 patients with depression were included. All included studies reported significant improvement following ketamine administration. Ketamine was well tolerated without serious adverse events. However, RCTs had a high risk of bias due to analysis methods and adverse events monitoring. Ketamine dosage varied from 0.5 to 1.25 mg/kg. The frequency of administration was daily to monthly. Several important limitations were identified, most notably the small number of RCTs. <b>Conclusions:</b> Taken together, preliminary evidence suggests the potential for antidepressant effect of oral ketamine. However, further research with large sample size and long follow-up period is needed to better determine the antisuicidal effect and efficacy in treatment-resistant depression.</p>","PeriodicalId":49358,"journal":{"name":"World Journal of Biological Psychiatry","volume":"24 7","pages":"545-557"},"PeriodicalIF":3.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9876933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory and oxidative endophenotypes in borderline personality disorder: A biomarker cluster analysis.","authors":"J M López-Villatoro,&nbsp;M Díaz-Marsá,&nbsp;A De la Torre-Luque,&nbsp;K S MacDowell,&nbsp;C Prittwitz,&nbsp;J C Leza,&nbsp;J L Carrasco","doi":"10.1080/15622975.2023.2183254","DOIUrl":"10.1080/15622975.2023.2183254","url":null,"abstract":"<p><strong>Objectives: </strong>This study is designed to search for aggrupation of inflammatory/oxidative biomarker alterations in borderline personality disorder (BPD) and their association with phenotypic features.</p><p><strong>Methodology: </strong>Inflammatory/nitrosative proteins were measures in plasma and peripheral blood mononuclear cells obtained from BPD patients. Patients were assessed on different clinical dimensions of BPD. Oxidative damage was tested by measuring TBARS, nitrites, catalase, GPx and SOD. Protein expression of IκBα, NFκB, iNOS, COX-2, PPARγ, Keap1, NQO1, Nrf2 and α7nAChR was also determined. Western blot and ELISA were used for measurements and a cluster analysis of inflammatory/oxidative biomarkers alterations was performed to investigate subgroups of patients with similar alterations and its relationship with clinical features of BPD.</p><p><strong>Results: </strong>69 patients were included in the study. Two inflammatory/nitrosative clusters of patients were found: Cluster 1 patients showed significantly higher levels of GPx, IκBα, keap1, NQO1, PPARγ, α7nAChR and Nrf2 than cluster 2 patients. These patients had significantly longer duration of illness, milder anxiety symptoms and lower prescription of antipsychotic drugs than cluster 2.</p><p><strong>Conclusions: </strong>Two clusters of BPD patients according to the inflammatory/nitrosative profiles were identified. Cluster 1 had increased antioxidant and anti-inflammatory biomarkers and was characterised by greater chronicity of illness but less acute symptomatic severity.</p>","PeriodicalId":49358,"journal":{"name":"World Journal of Biological Psychiatry","volume":"24 7","pages":"587-594"},"PeriodicalIF":3.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9880399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laterality in functional and metabolic state of the bulbectomised rat brain detected by ASL and ¹H MRS: A pilot study.","authors":"Iveta Pavlova,&nbsp;Eva Drazanova,&nbsp;Lucie Kratka,&nbsp;Petra Amchova,&nbsp;Ondrej Macicek,&nbsp;Jana Starcukova,&nbsp;Zenon Starcuk,&nbsp;Jana Ruda-Kucerova","doi":"10.1080/15622975.2022.2124450","DOIUrl":"https://doi.org/10.1080/15622975.2022.2124450","url":null,"abstract":"<p><strong>Objectives: </strong>Pilot study validating the animal model of depression - the bilateral olfactory bulbectomy in rats - by two nuclear magnetic resonance methods, indirectly detecting the metabolic state of the brain. Furthermore, the study focussed on potential differences in brain laterality.</p><p><strong>Methods: </strong>Arterial spin labelling assessed cerebral brain flow in prefrontal, sensorimotor, and piriform cortices, nucleus accumbens, hippocampus, thalamus, circle of Willis, and whole brain. Proton magnetic resonance spectroscopy provided information about relative metabolite concentrations in the cortex and hippocampus.</p><p><strong>Results: </strong>Arterial spin labelling found no differences in cerebral perfusion in the group comparison but revealed lateralisation in the thalamus of the control group and the sensorimotor cortex of the bulbectomized rats. Lower Cho/tCr and Cho/NAA levels were found in the right hippocampus in bulbectomized rats. The differences in lateralisation were shown in the hippocampus: mI/tCr in the control group, Cho/NAA, NAA/tCr, Tau/tCr in the model group, and in the cortex: NAA/tCr, mI/tCr in the control group.</p><p><strong>Conclusion: </strong>Olfactory bulbectomy affects the neuronal and biochemical profile of the rat brain laterally and, as a model of depression, was validated by two nuclear magnetic resonance methods.</p>","PeriodicalId":49358,"journal":{"name":"World Journal of Biological Psychiatry","volume":"24 5","pages":"414-428"},"PeriodicalIF":3.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10053472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin B12, homocysteine, and folic acid in patients suffering from bipolar disorders: Relationship with suicide.","authors":"Paola Mangiapane,&nbsp;Manuel Glauco Carbone,&nbsp;Alessandro Arone,&nbsp;Lucia Massa,&nbsp;Stefania Palermo,&nbsp;Walter Flamini,&nbsp;Elisabetta Parra,&nbsp;Benedetto Morana,&nbsp;Florinda Morana,&nbsp;Giovanni Bertini,&nbsp;Donatella Marazziti","doi":"10.1080/15622975.2022.2134589","DOIUrl":"https://doi.org/10.1080/15622975.2022.2134589","url":null,"abstract":"<p><strong>Objectives: </strong>Vitamin B12, folic acid, and homocysteine play a key role in 'one-carbon metabolism', involved in different brain processes. Altered levels have been reported in mood disorders (MDs), particularly in major depression (MDD), while the information in bipolar disorders (BDs) is limited. The present study aimed at assessing vitamin B12, homocysteine, and folic acid in 69 bipolar inpatients.</p><p><strong>Methods: </strong>Twenty-seven patients were diagnosed with BDI, 15 BDII, 16 schizoaffective disorders, and 11 MDD, according to DSM-5 criteria. The clinical picture was assessed by the MINI, HRSD, YMRS, and CGI. The blood parameters were measured according to common clinical-chemical methods.</p><p><strong>Results: </strong>Thirty-four patients had significantly lower vitamin B12, and 14 higher homocysteine levels than normative values. Folic acid levels were normal in the majority of the sample. Patients with a family history of suicide showed significantly lower levels of vitamin B12.</p><p><strong>Conclusions: </strong>Our results underline the utility of assessing vitamin B12, homocysteine, and folic acid in patients with BD. Although other studies are necessary, the present findings that lower levels of vitamin B12 seem typical of patients with a family history of suicide independently from the phase of illness suggest that they might constitute a possible predictor of suicide.</p>","PeriodicalId":49358,"journal":{"name":"World Journal of Biological Psychiatry","volume":"24 6","pages":"476-484"},"PeriodicalIF":3.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9745410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce.","authors":"Wolfgang Marx, Sam H Manger, Mark Blencowe, Greg Murray, Fiona Yan-Yee Ho, Sharon Lawn, James A Blumenthal, Felipe Schuch, Brendon Stubbs, Anu Ruusunen, Hanna Demelash Desyibelew, Timothy G Dinan, Felice Jacka, Arun Ravindran, Michael Berk, Adrienne O'Neil","doi":"10.1080/15622975.2022.2112074","DOIUrl":"10.1080/15622975.2022.2112074","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings.</p><p><strong>Methods: </strong>Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria.</p><p><strong>Results: </strong>Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework.</p><p><strong>Conclusions: </strong>Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care.</p>","PeriodicalId":49358,"journal":{"name":"World Journal of Biological Psychiatry","volume":"24 5","pages":"333-386"},"PeriodicalIF":3.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10972571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9679888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}