Consideración social de la enfermedad mental e implicaciones patogénicas del sistema inmuno/inflamatorio en la depresión mayor

Resum

Introduction: Social networking sites are a relatively new communication channel that enable interaction. The analysis of tweets could represent an effective indicator of “real world-performance”. Major Depressive Disorder (MDD) patients suffer a systemic inflammatory stage. Hypothesis and Objectives: Our aim was to quantify and characterize the interest of society in Mental Disorders (MD). Furthermore, we aimed to study alterations in monocytes and lymphocytes in MDD. Methods: We investigated tweets generated about MD among mainstream general communication media outlets, as well as tweets generated by Twitter users about Hikikomori and psychosis. As a control, we analyzed tweets generated about other relevant medical conditions. In order to study immunological alterations we recruited 30 patients and 30 matched healthy controls. We used polychromatic flow cytometry, Luminex and Elisa. Results: Mass media and the general public showed a preferential interest for psychiatric disorders on Twitter. Hikikomori is mostly addressed as a mental problem and is psychosis in frequently misused. MDD patients showed a marked alteration of circulating monocytes with expansion of the intermediate subset as well as increased serum levels of TNF, IL-1β, LBP and I-FABP. Furthermore, MDD patients showed an expansion of Tregs and their CD25hiFoxP3+ and CD25lowFoxP3+ subsets with increased frequency of those in TN activation/differentiation stage. Tregs showed increased CCR6 and CCR2 expression. Conclusions: Twitter users are interested in MD, especially for a select number of conditions. Stigmatic attitudes towards psychosis remain stable. MDD is associated to alterations in the number and function of monocytes and lymphocytes, to gut barrier damage and bacterial translocation