Background: Both obesity and depression are medical conditions associated with severe disability and biological abnormalities. Our aim was to study associations between Body Mass Index (BMI), depression and biological changes in women affected by overweight or obesity. Methods: Depressive symptoms were evaluated by the Beck Depression Inventory II (BDI-II) questionnaire in 200 women affected by overweight/obesity (mean age of the sample 52.7 ± 12.9 years, BMI 33.8 ± 5.5 kg/m²). A blood sample was obtained for evaluation of biochemical (oxytocin and vitamin D), inflammatory and epigenetic (methylation of clock genes) parameters. Multivariable linear regression models were used to study the association between BMI or severity of depressive symptoms (BDI-II scores) with different biomarkers. Results: BMI was found to be associated with severity of depressive symptoms (p = 0.050). Severity of obesity resulted to be associated with lower plasma levels of oxytocin (p = 0.053), vitamin D deficiency (p = 0.006) and higher plasma levels of IFN-γ (p = 0.004), IL-6 (p = 0.013), IL-7 (p = 0.013), TNF-alpha (p = 0.036) and chemokine ligand 3 (CCL3) (p = 0.013, R² = 0.03). Severity of depression was significantly associated with more methylation of clock genes CRY1 (p = 0.034, R² = 0.16) and CRY2 (p = 0.019, R² = 0.47). More severe depression together with higher levels of IL-8 strongly predicted lower methylation of CLOCK gene (p = 0.009); Conclusions: Different biological abnormalities have been found to be independently associated with BMI and severity of depressive symptoms in women affected by overweight/obesity. The complex interplay between overweight, depression and biological changes will have to be better clarified by future studies.

Background: Treatment-resistant depression (TRD) is a debilitating condition associated with unmet clinical needs. Few studies have explored clinical characteristics and serum biomarkers associated with TRD. Aims: We investigated whether there were differences in clinical and biochemical variables between patients affected by TRD than those without. Methods: We recruited 343 patients (165 males and 178 females) consecutively hospitalized for MDD to the inpatient clinics affiliated to the Fondazione IRCCS Policlinico, Milan, Italy (n = 234), and ASST Monza, Italy (n = 109). Data were obtained through a screening of the clinical charts and blood analyses conducted during the hospitalization. Results: TRD versus non-TRD patients resulted to be older (p = 0.001), to have a longer duration of illness (p < 0.001), to be more currently treated with a psychiatric poly-therapy (p < 0.001), to have currently more severe depressive symptoms as showed by the Hamilton Depression Rating Scale (HAM-D) scores (p = 0.016), to have lower bilirubin plasma levels (p < 0.001). In addition, more lifetime suicide attempts (p = 0.035), more antidepressant treatments before the current episode (p < 0.001), and a lower neutrophil to lymphocyte ratio at borderline statistically significant level (p = 0.060) were all associated with the TRD group. Conclusion: We identified candidate biomarkers associated with TRD such as bilirubin plasma levels and NLR, to be confirmed by further studies. Moreover, TRD seems to be associated with unfavorable clinical factors such as a predisposition to suicidal behaviors. Future research should replicate these results to provide robust data in support of the identification of new targets of treatment and implementation of prevention strategies for TRD.

Atopic dermatitis (AD) is an inflammatory skin disease. Patients with AD are prone to develop anxiety and mood disorders. Aim of this study is to investigate if treatment with dupilumab may improve mental health status of patients affected by AD. A total of 66 patients with severe AD were included: 24 subjects were candidate or have just started (one month) treatment with dupilumab, and 42 have been in treatment for one year. 25.8%, 30.3%, and 45.5% of the total sample showed, respectively, clinically significant anxiety, depression, and symptoms of Internet addiction. Patients with anxiety symptoms resulted to have more severe AD, more sleep problems (P = 0.028), less quality of life (P = 0.001), more severe depressive symptoms (P < 0.001), to be more frequently women (P = 0.016), to be less frequently treated with dupilumab for one year (P = 0.025). Similarly, patients with clinically significant depressive symptoms resulted to have more severe AD, more sleep problems (P = 0.003), less quality of life (P < 0.001), more severe anxiety symptoms (P < 0.001), to be less frequently treated with dupilumab for one year (P = 0.008). Patients with AD treated for one year with dupilumab showed a better mental health profile in terms of less severe anxiety and depression with respect to their counterparts.

Bipolar Disorder (BD) alternates depressive, manic or hypomanic phases. A manic episode (ME) is the main psychopathological condition of BD and it often requires hospitalization. Air pollution is thought to play a role in onset and exacerbation of several psychiatric disorders. We aimed to verify the association between exposure to particulate matter ≤10 μm (PM10) and ME severity, assessed through the Young Mania Rating Scale (YMRS). We evaluated clinical records regarding 414 hospital admissions of 186 patients residing in Milan (Italy), hospitalized for ME in the Psychiatry Unit of the Policlinico Hospital from 2007 to 2019. Patients were assigned mean daily PM10 and apparent temperature levels of the Milan municipality. As exposure windows, we considered single days preceding hospitalization (lag0 to 7) and their average estimates (lag0-1 to 0-7). We applied mixed effect models, adjusted for relevant confounders. Short-term PM10 exposure was associated with a reduction in YMRS, both when considering daily lags [β: -0.43 (95% Confidence Interval: -0.83; -0.03) at lag0] and their average [-0.47 (-0.90; -0.04) at lag0-1]. YMRS was higher in psychotic patients (24.8) and lower in ME with mixed components (15.5) if compared to episodes characterized by neither mixed nor psychotic features (17.4, p < 0.001). While PM10 did not influence the risk of psychotic symptoms at admission, it was associated with a higher risk of ME with mixed features, with Odds Ratios ranging from 2.43 (1.02; 5.76) at lag0 to 3.60 (1.22; 10.7) at lag0-2. Our findings show that increasing levels of PM10 move the ME towards the depressive pole of the BD spectrum and augment the probability of hospitalization for ME with mixed components. These results have important clinical implications, as mixed features worsen the course of ME and make the management of bipolar patients challenging.

Background: Major depressive disorder (MDD) is one of the most prevalent medical conditions worldwide. Different factors were found to play a role in its etiology, including environmental ones (e.g., air pollution). The aim of this study was to evaluate the association between air pollution exposure and MDD severity. Methods: Four hundred sixteen MDD subjects were recruited. Severity of MDD and functioning were evaluated through five rating scales: Montgomery–Asberg Depression Rating Scale (MADRS), Hamilton Depression Rating Scale (HAMD), Clinical Global Impression (CGI), Global Assessment of Functioning (GAF), and Sheehan Disability Scale (SDS). Daily mean estimates of particulate matter with diameter ≤10 (PM10) and 2.5 μm (PM2.5), nitrogen dioxide (NO₂), and apparent temperature (AT) were estimated based on subjects’ residential addresses. Daily estimates of the 2 weeks preceding recruitment were averaged to obtain cumulative exposure. Multivariate linear and ordinal regression models were applied to assess the associations between air pollutants and MDD severity, overall and stratifying by hypersusceptibility and AT. Results: Two-thirds of subjects were women and one-third had a family history of depression. Most women had depression with symptoms of anxiety, while men had predominantly melancholic depression. NO₂ exposure was associated with worsening of MDD severity (HAMD: β = 1.94, 95% confidence interval [CI], [0.41–3.47]; GAF: β = −1.93, 95% CI [−3.89 to 0.02]), especially when temperatures were low or among hypersusceptible subjects. PM exposure showed an association with MDD severity only in these subgroups. Conclusions: Exposure to air pollution worsens MDD severity, with hypersusceptibility and lower temperatures being exacerbating factors.