Mapping the network biology of metabolic response to stress in posttraumatic stress disorder and obesity.

The co-occurrence of stress-induced posttraumatic stress disorder (PTSD) and obesity is common, particularly among military personnel but the link between these conditions is unclear. Individuals with comorbid PTSD and obesity manifest other physical and psychological problems, which significantly diminish their quality of life. Current understanding of the pathways connecting stress to PTSD and obesity is focused largely on behavioral mediators alone with little consideration of the biological regulatory mechanisms that underlie their co-occurrence. In this work, we leverage prior knowledge to systematically highlight such bio-behavioral mechanisms and inform on the design of confirmatory pilot studies. We use natural language processing (NLP) to extract documented regulatory interactions involved in the metabolic response to stress and its impact on obesity and PTSD from over 8 million peer-reviewed papers. The resulting network describes the propagation of stress to PTSD and obesity through 34 metabolic mediators using 302 documented regulatory interactions supported by over 10,000 citations. Stress jointly affected both conditions through 21 distinct pathways involving only two intermediate metabolic mediators out of a total of 76 available paths through this network. Moreover, oxytocin (OXT), Neuropeptide-Y (NPY), and cortisol supported an almost direct propagation of stress to PTSD and obesity with different net effects. Although stress upregulated both NPY and cortisol, the downstream effects of both markers are reported to relieve PTSD severity but exacerbate obesity. The stress-mediated release of oxytocin, however, was found to concurrently downregulate the severity of both conditions. These findings highlight how a network-informed approach that leverages prior knowledge might be used effectively in identifying key mediators like OXT though experimental verification of signal transmission dynamics through each path will be needed to determine the actual likelihood and extent of each marker's participation.

High Prevalence of Borderline Personality Disorder Among Psychiatric Inpatients Admitted for Suicidality.

Borderline personality disorder (BPD) is associated with high risk of suicidality and high rates of health care utilization; however, the prevalence and characteristics of BPD among inpatients admitted for suicidality are unknown. In the present study of 72 adult psychiatric inpatients admitted for suicide risk, BPD was highly prevalent (n = 31; 43.1%), but 68% were misdiagnosed by admitting providers. Compared to patients without BPD, those with BPD were significantly younger, were prescribed more psychiatric medications, were more depressed, and had greater suicide ideation. Patients with BPD were also three times as likely to be readmitted to a psychiatric hospital at 30, 90, and 180 days postdischarge for an average of almost 9 days of inpatient care per patient for the first 180 days. In this sample, BPD was highly prevalent, underdiagnosed, and associated with frequent readmissions, findings that highlight the importance of improved recognition and access to specialized treatments.

Cognitive and affective factors predicting daily somatic complaints in college students.

Evidence suggests that cumulative somatic complaints predict health care utilization in college students. The symptom perception hypothesis and the response expectancy theory are 2 theories concerning the generation of somatic complaints. The symptom perception hypothesis suggests that negative affect influences daily somatic complaints, whereas the response expectancy theory surmises somatic complaint generation relates to response expectancies. Some evidence suggests that understanding the complex interplay of these factors may enhance prediction of daily somatic complaints. This study examines the combined effects of state negative affect, trait negative affect, and response expectancies in predicting daily somatic complaints. A total of 95 college students took part in a 2-part study composed of 1 in-lab session followed by completion of up to 7 daily diaries. Results show that state negative affect, trait negative affect, and response expectancies all uniquely predict daily somatic complaints. Our results support a cognitive-affective basis for somatic complaints and suggest future research integrating biopsychosocial factors may be useful in increasing our understanding. Furthermore, our results suggest potential intervention targets when counseling college students experiencing somatic complaints without physical origins. (PsycINFO Database Record