@article{LeutritzvanBraamPreisetal.2023,
  author    = {Leutritz, Anna Linda and van Braam, Lara and Preis, Katharina and Gehrmann, Andrea and Scherf-Clavel, Maike and Fiedler, Katrin and Unterecker, Stefan and Kittel-Schneider, Sarah},
  title     = {Psychotropic medication in pregnancy and lactation and early development of exposed children},
  series = {British Journal of Clinical Pharmacology},
  volume    = {89},
  journal   = {British Journal of Clinical Pharmacology},
  number    = {2},
  doi       = {10.1111/bcp.15533},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-318954},
  pages     = {737 -- 750},
  year      = {2023},
  abstract  = {There is still limited knowledge about alterations of blood concentrations of psychotropic drugs during pregnancy, the transfer of psychotropic drugs into breastmilk and the effects on exposed children. We investigated changes in concentrations of psychopharmacological medication during pregnancy and lactation in serum and breastmilk at different time points in a naturalistic sample of 60 mothers and observed the development of the exposed children in the first 12 months. We found a decrease in serum concentrations from the first to the second trimester of amitriptyline, duloxetine, escitalopram, quetiapine and sertraline. Citalopram stayed rather stable during pregnancy, sertraline levels interestingly increased again from the second to the third trimester. High concentration-by-dose ratios in breastmilk were found for venlafaxine as well as lamotrigine, low for quetiapine and clomipramine. Similarly, clomipramine and quetiapine showed low milk/serum-penetration ratios. Regarding the birth outcome measures in children, we found no significant differences between in utero exposed compared to nonexposed newborns. There were no significant differences in the development in the first 12 months. Psychotropic medication in the peripartum needs a balancing of risks and benefits and a continuous therapeutic drug monitoring can be a guidance for clinicians to monitor drug alteration patterns, which are likely to occur due to physiological pregnancy-associated changes in pharmacokinetics. Accordingly, therapeutic drug monitoring can optimize a medication in pregnancy and lactation with the lowest effective dose.},
  language  = {en}
}
@article{KopfGloecknerAlthenetal.2023,
  author    = {Kopf, Juliane and Gl{\"o}ckner, Stefan and Althen, Heike and Cevada, Thais and Schecklmann, Martin and Dresler, Thomas and Kittel-Schneider, Sarah and Reif, Andreas},
  title     = {Neural responses to a working memory task in acute depressed and remitted phases in bipolar patients},
  series = {Brain Sciences},
  volume    = {13},
  journal   = {Brain Sciences},
  number    = {5},
  issn      = {2076-3425},
  doi       = {10.3390/brainsci13050744},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-313509},
  year      = {2023},
  abstract  = {(1) Cognitive impairments such as working memory (WM) deficits are amongst the most common dysfunctions characterizing bipolar disorder (BD) patients, severely contributing to functional impairment. We aimed to investigate WM performance and associated brain activation during the acute phase of BD and to observe changes in the same patients during remission. (2) Frontal brain activation was recorded using functional near-infrared spectroscopy (fNIRS) during n-back task conditions (one-back, two-back and three-back) in BD patients in their acute depressive (n = 32) and remitted (n = 15) phases as well as in healthy controls (n = 30). (3) Comparison of BD patients during their acute phase with controls showed a trend (p = 0.08) towards lower dorsolateral prefrontal cortex (dlPFC) activation. In the remitted phase, BD patients showed lower dlPFC and ventrolateral prefrontal cortex (vlPFC) activation (p = 0.02) compared to controls. No difference in dlPFC and vlPFC activation between BD patients' phases was found. (4) Our results showed decreased working memory performance in BD patients during the working memory task in the acute phase of disease. Working memory performance improved in the remitted phase of the disease but was still particularly attenuated for the more demanding conditions.},
  language  = {en}
}
@article{HampfScherfClavelWeissetal.2023,
  author    = {Hampf, Chantal and Scherf-Clavel, Maike and Weiß, Carolin and Kl{\"u}pfel, Catherina and Stonawski, Saskia and Hommers, Leif and Lichter, Katharina and Erhardt-Lehmann, Angelika and Unterecker, Stefan and Domschke, Katharina and Kittel-Schneider, Sarah and Menke, Andreas and Deckert, J{\"u}rgen and Weber, Heike},
  title     = {Effects of anxious depression on antidepressant treatment response},
  series = {International Journal of Molecular Sciences},
  volume    = {24},
  journal   = {International Journal of Molecular Sciences},
  number    = {24},
  issn      = {1422-0067},
  doi       = {10.3390/ijms242417128},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-355801},
  year      = {2023},
  abstract  = {Anxious depression represents a subtype of major depressive disorder and is associated with increased suicidality, severity, chronicity and lower treatment response. Only a few studies have investigated the differences between anxious depressed (aMDD) and non-anxious depressed (naMDD) patients regarding treatment dosage, serum-concentration and drug-specific treatment response. In our naturalistic and prospective study, we investigated whether the effectiveness of therapy including antidepressants (SSRI, SNRI, NaSSA, tricyclics and combinations) in aMDD patients differs significantly from that in naMDD patients. In a sample of 346 patients, we calculated the anxiety somatization factor (ASF) and defined treatment response as a reduction (≥50\%) in the Hamilton Depression Rating Scale (HDRS)-21 score after 7 weeks of pharmacological treatment. We did not observe an association between therapy response and the baseline ASF-scores, or differences in therapy outcomes between aMDD and naMDD patients. However, non-responders had higher ASF-scores, and at week 7 aMDD patients displayed a worse therapy outcome than naMDD patients. In subgroup analyses for different antidepressant drugs, venlafaxine-treated aMDD patients showed a significantly worse outcome at week 7. Future prospective, randomized-controlled studies should address the question of a worse therapy outcome in aMDD patients for different psychopharmaceuticals individually.},
  language  = {en}
}
@article{McNeillRadtkeNieberleretal.2023,
  author    = {McNeill, Rhiannon V. and Radtke, Franziska and Nieberler, Matthias and Koreny, Carolin and Chiocchetti, Andreas G. and Kittel-Schneider, Sarah},
  title     = {Generation of four human induced pluripotent stem cells derived from ADHD patients carrying different genotypes for the risk SNP rs1397547 in the ADHD-associated gene ADGRL3},
  series = {Stem Cell Research},
  volume    = {67},
  journal   = {Stem Cell Research},
  doi       = {10.1016/j.scr.2023.103016},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-350099},
  year      = {2023},
  abstract  = {Single nucleotide polymorphisms (SNPs) in the ADGRL3 gene have been significantly associated with the development of ADHD, the aetiology of which remains poorly understood. The rs1397547 SNP has additionally been associated with significantly altered ADGRL3 transcription. We therefore generated iPSCs from two wild type ADHD patients, and two ADHD patients heterozygous for the risk SNP. With this resource we aim to facilitate further investigation into the complex and heterogenous pathology of ADHD. Furthermore, we demonstrate the feasibility of using magnetic activated cell sorting to allow the unbiased selection of fully reprogrammed iPSCs.},
  language  = {en}
}
@article{KittelSchneiderFeliceBuhagiaretal.2022,
  author    = {Kittel-Schneider, Sarah and Felice, Ethel and Buhagiar, Rachel and Lambregtse-van den Berg, Mijke and Wilson, Claire A. and Banjac Baljak, Visnja and Vujovic, Katarina Savic and Medic, Branislava and Opankovic, Ana and Fonseca, Ana and Lupattelli, Angela},
  title     = {Treatment of peripartum depression with antidepressants and other psychotropic medications: a synthesis of clinical practice guidelines in Europe},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {19},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {4},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph19041973},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-262130},
  year      = {2022},
  abstract  = {This study examined (1) the availability and content of national CPGs for treatment of peripartum depression, including comorbid anxiety, with antidepressants and other psychotropics across Europe and (2) antidepressant and other psychotropic utilization data as an indicator of prescribers' compliance to the guidelines. We conducted a search using Medline and the Guidelines International Network database, combined with direct e-mail contact with national Riseup-PPD COST ACTION members and researchers within psychiatry. Of the 48 European countries examined, we screened 41 records and included 14 of them for full-text evaluation. After exclusion of ineligible and duplicate records, we included 12 CPGs. Multiple CPGs recommend antidepressant initiation or continuation based on maternal disease severity, non-response to first-line non-pharmacological interventions, and after risk-benefit assessment. Advice on treatment of comorbid anxiety is largely missing or unspecific. Antidepressant dispensing data suggest general prescribers' compliance with the preferred substances of the CPG, although country-specific differences were noted. To conclude, there is an urgent need for harmonized, up-to-date CPGs for pharmacological management of peripartum depression and comorbid anxiety in Europe. The recommendations need to be informed by the latest available evidence so that healthcare providers and women can make informed, evidence-based decisions about treatment choices.},
  language  = {en}
}
@article{HuebnerWolfgangTheisetal.2022,
  author    = {H{\"u}bner, Theresa and Wolfgang, Tanja and Theis, Ann-Catrin and Steber, Magdalena and Wiedenmann, Lea and W{\"o}ckel, Achim and Diessner, Joachim and Hein, Grit and Gr{\"u}ndahl, Marthe and K{\"a}mmerer, Ulrike and Kittel-Schneider, Sarah and Bartmann, Catharina},
  title     = {The impact of the COVID-19 pandemic on stress and other psychological factors in pregnant women giving birth during the first wave of the pandemic},
  series = {Reproductive Health},
  volume    = {19},
  journal   = {Reproductive Health},
  number    = {1},
  doi       = {10.1186/s12978-022-01493-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300189},
  year      = {2022},
  abstract  = {Background The onset of mental illness such as depression and anxiety disorders in pregnancy and postpartum period is common. The coronavirus induced disease 2019 (COVID-19) pandemic and the resulting public policy responses represent an exceptional situation worldwide and there are hints for adverse psychosocial impact, hence, the study of psychological effects of the pandemic in women during hospitalization for delivery and in the postpartum period is highly relevant. Methods Patients who gave birth during the first wave of the COVID-19 pandemic in Germany (March to June 2020) at the Department of Obstetrics and Gynecology, University of W{\"u}rzburg, Germany, were recruited at hospital admission for delivery. Biosamples were collected for analysis of SARS-CoV-2 infection and various stress hormones and interleukin-6 (IL-6). In addition to sociodemographic and medical obstetric data, survey questionnaires in relation to concerns about and fear of COVID-19, depression, stress, anxiety, loneliness, maternal self-efficacy and the mother-child bonding were administered at T1 (delivery stay) and T2 (3-6 months postpartum). Results In total, all 94 recruited patients had a moderate concern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at T1 with a significant rise at T2. This concern correlated with low to low-medium general psychosocial stress levels and stress symptoms, and the women showed a significant increase of active coping from T1 to T2. Anxiety levels were low and the Edinburgh Postnatal Depression Scale showed a medium score of 5 with a significant (T1), but only week correlation with the concerns about SARS-CoV-2. In contrast to the overall good maternal bonding without correlation to SARS-CoV-2 concern, the maternal self-efficiency correlated negatively with the obstetric impairment caused by the COVID-19 pandemic. Conclusion Obstetric patients` concerns regarding SARS-CoV-2 and the accompanying pandemic increased during the course of the pandemic correlating positively with stress and depression. Of note is the increase in active coping over time and the overall good mother-child-bonding. Maternal self-efficacy was affected in part by the restrictions of the pandemic.},
  language  = {en}
}
@article{KittelSchneiderDavidovaKaloketal.2022,
  author    = {Kittel-Schneider, Sarah and Davidova, Petra and Kalok, Miriam and Essel, Corina and Ahmed, Fadia Ben and Kingeter, Yasmina and Matentzoglu, Maria and Leutritz, Anna and Kersken, Katharina and Koreny, Carolin and Weber, Heike and Kollert, Leoniee and McNeill, Rihannon V. and Reif, Andreas and Bahlmann, Franz and Trautmann-Villalba, Patricia},
  title     = {A pilot study of multilevel analysis of BDNF in paternal and maternal perinatal depression},
  series = {Archives of Women's Mental Health},
  volume    = {25},
  journal   = {Archives of Women's Mental Health},
  number    = {1},
  issn      = {1435-1102},
  doi       = {10.1007/s00737-021-01197-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-268849},
  pages     = {237-249},
  year      = {2022},
  abstract  = {Depression in the perinatal period is common in mothers worldwide. Emerging research indicates that fathers are also at risk of developing perinatal depression. However, knowledge regarding biological risk factors and pathophysiological mechanisms of perinatal depression is still scarce, particularly in fathers. It has been suggested that the neurotrophin BDNF may play a role in maternal perinatal depression; however, there is currently no data regarding paternal perinatal depression. For this pilot study, 81 expecting parents were recruited and assessed at several time points. We screened for depression using EPDS and MADRS, investigated several psychosocial variables, and took blood samples for BDNF val66met genotyping, epigenetic, and protein analysis. Between pregnancy and 12 months postpartum (pp), we found that 3.7 to 15.7\% of fathers screened positive for depression, and 9.6 to 24\% of mothers, with at least a twofold increased prevalence in both parents using MADRS compared with EPDS. We also identified several psychosocial factors associated with perinatal depression in both parents. The data revealed a trend that lower BDNF levels correlated with maternal depressive symptoms at 3 months pp. In the fathers, no significant correlations between BDNF and perinatal depression were found. Pregnant women demonstrated lower BDNF methylation and BDNF protein expression compared with men; however, these were found to increase postpartum. Lastly, we identified correlations between depressive symptoms and psychosocial/neurobiological factors. The data suggest that BDNF may play a role in maternal perinatal depression, but not paternal.},
  language  = {en}
}
@article{JansonWillekeZaibertetal.2022,
  author    = {Janson, Patrick and Willeke, Kristina and Zaibert, Lisa and Budnick, Andrea and Bergh{\"o}fer, Anne and Kittel-Schneider, Sarah and Heuschmann, Peter U. and Zapf, Andreas and Wildner, Manfred and Stupp, Carolin and Keil, Thomas},
  title     = {Mortality, morbidity and health-related outcomes in informal caregivers compared to non-caregivers: a systematic review},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {19},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {10},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph19105864},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-275219},
  year      = {2022},
  abstract  = {A systematic overview of mental and physical disorders of informal caregivers based on population-based studies with good methodological quality is lacking. Therefore, our aim was to systematically summarize mortality, incidence, and prevalence estimates of chronic diseases in informal caregivers compared to non-caregivers. Following PRISMA recommendations, we searched major healthcare databases (CINAHL, MEDLINE and Web of Science) systematically for relevant studies published in the last 10 years (without language restrictions) (PROSPERO registration number: CRD42020200314). We included only observational cross-sectional and cohort studies with low risk of bias (risk scores 0-2 out of max 8) that reported the prevalence, incidence, odds ratio (OR), hazard ratio (HR), mean- or sum-scores for health-related outcomes in informal caregivers and non-caregivers. For a thorough methodological quality assessment, we used a validated checklist. The synthesis of the results was conducted by grouping outcomes. We included 22 studies, which came predominately from the USA and Europe. Informal caregivers had a significantly lower mortality than non-caregivers. Regarding chronic morbidity outcomes, the results from a large longitudinal German health-insurance evaluation showed increased and statistically significant incidences of severe stress, adjustment disorders, depression, diseases of the spine and pain conditions among informal caregivers compared to non-caregivers. In cross-sectional evaluations, informal caregiving seemed to be associated with a higher occurrence of depression and of anxiety (ranging from 4 to 51\% and 2 to 38\%, respectively), pain, hypertension, diabetes and reduced quality of life. Results from our systematic review suggest that informal caregiving may be associated with several mental and physical disorders. However, these results need to be interpreted with caution, as the cross-sectional studies cannot determine temporal relationships. The lower mortality rates compared to non-caregivers may be due to a healthy-carer bias in longitudinal observational studies; however, these and other potential benefits of informal caregiving deserve further attention by researchers.},
  language  = {en}
}
@article{BrunkhorstKanaanTrautmannSchreiberetal.2021,
  author    = {Brunkhorst-Kanaan, Nathalie and Trautmann, Sandra and Schreiber, Yannick and Thomas, Dominique and Kittel-Schneider, Sarah and Gurke, Robert and Geisslinger, Gerd and Reif, Andreas and Tegeder, Irmgard},
  title     = {Sphingolipid and endocannabinoid profiles in adult attention deficit hyperactivity disorder},
  series = {Biomedicines},
  volume    = {9},
  journal   = {Biomedicines},
  number    = {9},
  issn      = {2227-9059},
  doi       = {10.3390/biomedicines9091173},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-246080},
  year      = {2021},
  abstract  = {Genes encoding endocannabinoid and sphingolipid metabolism pathways were suggested to contribute to the genetic risk towards attention deficit hyperactivity disorder (ADHD). The present pilot study assessed plasma concentrations of candidate endocannabinoids, sphingolipids and ceramides in individuals with adult ADHD in comparison with healthy controls and patients with affective disorders. Targeted lipid analyses of 23 different lipid species were performed in 71 mental disorder patients and 98 healthy controls (HC). The patients were diagnosed with adult ADHD (n = 12), affective disorder (major depression, MD n = 16 or bipolar disorder, BD n = 6) or adult ADHD with comorbid affective disorders (n = 37). Canonical discriminant analysis and CHAID analyses were used to identify major components that predicted the diagnostic group. ADHD patients had increased plasma concentrations of sphingosine-1-phosphate (S1P d18:1) and sphinganine-1-phosphate (S1P d18:0). In addition, the endocannabinoids, anandamide (AEA) and arachidonoylglycerol were increased. MD/BD patients had increased long chain ceramides, most prominently Cer22:0, but low endocannabinoids in contrast to ADHD patients. Patients with ADHD and comorbid affective disorders displayed increased S1P d18:1 and increased Cer22:0, but the individual lipid levels were lower than in the non-comorbid disorders. Sphingolipid profiles differ between patients suffering from ADHD and affective disorders, with overlapping patterns in comorbid patients. The S1P d18:1 to Cer22:0 ratio may constitute a diagnostic or prognostic tool.},
  language  = {en}
}
@article{BartmannFischerHuebneretal.2021,
  author    = {Bartmann, Catharina and Fischer, Leah-Maria and H{\"u}bner, Theresa and M{\"u}ller-Reiter, Max and W{\"o}ckel, Achim and McNeill, Rhiannon V. and Schlaiss, Tanja and Kittel-Schneider, Sarah and K{\"a}mmerer, Ulrike and Diessner, Joachim},
  title     = {The effects of the COVID-19 pandemic on psychological stress in breast cancer patients},
  series = {BMC Cancer},
  volume    = {21},
  journal   = {BMC Cancer},
  doi       = {10.1186/s12885-021-09012-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265802},
  year      = {2021},
  abstract  = {Background: The majority of breast cancer patients are severely psychologically affected by breast cancer diagnosis and subsequent therapeutic procedures. The COVID-19 pandemic and associated restrictions on public life have additionally caused significant psychological distress for much of the population. It is therefore plausible that breast cancer patients might be particularly susceptible to the additional psychological stress caused by the pandemic, increasing suffering. In this study we therefore aimed to assess the level of psychological distress currently experienced by a defined group of breast cancer patients in our breast cancer centre, compared to distress levels preCOVID-19 pandemic. Methods: Female breast cancer patients of all ages receiving either adjuvant, neoadjuvant, or palliative therapies were recruited for the study. All patients were screened for current or previous COVID-19 infection. The participants completed a self-designed COVID-19 pandemic questionnaire, the Stress and Coping Inventory (SCI), the National Comprehensive Cancer Network (R) (NCCN (R)) Distress Thermometer (DT), the European Organization for Research and Treatment of Cancer (EORTC) QLQ C30, and the BR23. Results: Eighty-two breast cancer patients were included. Therapy status and social demographic factors did not have a significant effect on the distress caused by the COVID-19 pandemic. The results of the DT pre and during COVID-19 pandemic did not differ significantly. Using the self-designed COVID-19 pandemic questionnaire, we detected three distinct subgroups demonstrating different levels of concerns in relation to SARS-CoV-2. The subgroup with the highest levels of concern reported significantly decreased life quality, related parameters and symptoms. Conclusions: This monocentric study demonstrated that the COVID-19 pandemic significantly affected psychological health in a subpopulation of breast cancer patients. The application of a self-created "COVID-19 pandemic questionnaire"could potentially be used to help identify breast cancer patients who are susceptible to increased psychological distress due to the COVID-19 pandemic, and therefore may need additional intensive psychological support.},
  language  = {en}
}