Nicole Beaulieu Perez

Faculty

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Nicole Beaulieu Perez

PhD PMHNP RN

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Nicole Beaulieu Perez's additional information

Nicole Beaulieu Perez is an assistant professor of nursing. She is a nurse scientist and board-certified psychiatric mental health nurse practitioner dedicated to improving whole health, advancing health equity, and reducing mental health stigma. Her research examines biological and social underpinnings of depression across diverse populations of women with chronic conditions (diabetes, cardiovascular disease, HIV). Perez’s interdisciplinary scholarship integrates precision health (e.g. epigenetic, gut microbiome) and advanced statistical approaches to disentangle depression with the goal of developing strategies to improve clinical identification and develop strategies for populations most at risk.

Currently, Perez is principal investigator of a P20 center pilot award funded by the National Institute of Nursing Research in which she is investigating inflammatory and epigenetic biomarkers of depressive symptom phenotypes in type 2 diabetes among women with and without HIV. She has published widely on the topics of mental health, the intersection of depression with chronic illnesses, and disparities in mental healthcare. She has presented her work at national and international nursing and translational science conferences, and her research has been featured in HuffPost, Fortune, and The Root.

For more than a decade, Perez has been a practicing psychiatric nurse and nurse practitioner across inpatient, rural clinic, and urban shelter settings, experiences that fuel her commitment to improving mental health and reducing disparities through her research and teaching. Prior to poining the NYU faculty, she completed postdoctoral training at NYU Meyers Center for Precision Health in Diverse Populations and a TL1-funded predoctoral fellowship through NYU Grossman School of Medicine Clinical and Translational Science Institute. She has also served as adjunct clinical faculty at Meyers, teaching in the graduate research courses and undergraduate psychiatric mental health courses. Perez earned her PhD from NYU Meyers College of Nursing and her BSN and MSN from the University of Florida.

PhD, Nursing Research and Theory Development - New York University
MSN, Psychiatric Mental Health Advanced Practice Nursing- University of Florida
BSN, Professional Nursing- University of Florida

Mental health
Chronic disease
Underserved populations

American Academy of Nursing
New York Academy of Sciences
International Society of Nurses in Genetics
Eastern Nursing Research Society
International Society of Psychiatric Nurses
American Psychiatric Nurses Association
Sigma Theta Tau International Honor Society of Nursing

Faculty Honors Awards

Distinguished PhD Student Award, NYU Meyers (2021)
Ellen D. Baer Scholarship, NYU Meyers (2020) (2020)
Alumnae Association Scholarship, Mount Sinai Hospital School of Nursing (2020)
Board of Directors Scholarship, American Psychiatric Nurses Association (2020)
Pauline Greenridge Scholarship, NYU Meyers (2019)
Fred Schmidt Scholarship, NYU Meyers (2019)
Psychiatric Mental Health Nursing Scholar, Barbara Jonas Foundation (2017)
Rose Rivers’ Leadership Fellow, University of Florida Health (2012)
Excellence in Research Award, University of Florida (2011)
Sigma Theta Tau International Honor Society of Nursing Inductee, University of Florida (2010)

Publications

Study Protocol Using Cohort Data and Latent Variable Modeling to Guide Sampling Women with Type 2 Diabetes and Depressive Symptoms

Perez, N. B., D’Eramo Melkus, G., Yu, G., Brown-Friday, J., Anastos, K., & Aouizerat, B. (2023). Nursing Research, 72(5), 409-415. 10.1097/NNR.0000000000000669
Abstract
Abstract
Background Depression affects one in three women with Type 2 diabetes, and this concurrence significantly increases the risks of diabetes complications, disability, and early mortality. Depression is underrecognized because of wide variation in presentation and the lack of diagnostic biomarkers. Converging evidence suggests inflammation is a shared biological pathway in diabetes and depression. Overlapping epigenetic associations and social determinants of diabetes and depression implicate inflammatory pathways as a common thread. Objectives This article describes the protocol and methods for a pilot study aimed to examine associations between depressive symptoms, inflammation, and social determinants of health among women with Type 2 diabetes. Methods This is an observational correlational study that leverages existing longitudinal data from the Women's Interagency HIV Study (WIHS), a multicenter cohort of HIV seropositive (66%) and HIV seronegative (33%) women, to inform purposive sampling of members from latent subgroups emergent from a prior retrospective cohort-wide analysis. Local active cohort participants from the Bronx study site are then selected for the study. The WIHS recently merged with the Multicenter Aids Cohort Study (MACS) to form the MACS/WIHS Combined Cohort Study. Latent subgroups represent distinct symptom trajectories resultant from a growth mixture model analysis of biannually collected depressive symptom data. Participants complete surveys (symptom and social determinants) and provide blood samples to analyze plasma levels and DNA methylation of genes that encode for inflammatory markers (CRP, IL-6, TNF-). Correlation and regression analysis will be used to estimate the effect sizes between depressive symptoms and inflammatory markers, clinical indices (body mass index, hemoglobin A1C, comorbidities), and social determinants of health. Results The study began in January 2022, and completed data collection is estimated by early 2023. We hypothesize that depressive symptom severity will associate with higher levels of inflammation, clinical indices (e.g., higher hemoglobin A1C), and exposure to specific social determinants of health (e.g., lower income, nutritional insecurity). Discussion Study findings will provide the basis for future studies aimed at improving outcomes for women with Type 2 diabetes by informing the development and testing of precision health strategies to address and prevent depression in populations most at risk.

Associations Between DNA Methylation Age Acceleration, Depressive Symptoms, and Cardiometabolic Traits in African American Mothers From the InterGEN Study

Perez, N. B., Vorderstrasse, A., Yu, G., D’Eramo Melkus, G., Wright, F., Ginsberg, S. D., Crusto, C. A., Sun, Y. V., & Taylor, J. (2022). Epigenetics Insights, 15. 10.1177/25168657221109781
Abstract
Abstract
Background: African American women (AAW) have a high risk of both cardiometabolic (CM) illness and depressive symptoms. Depressive symptoms co-occur in individuals with CM illness at higher rates than the general population, and accelerated aging may explain this. In this secondary analysis, we examined associations between age acceleration; depressive symptoms; and CM traits (hypertension, diabetes mellitus [DM], and obesity) in a cohort of AAW. Methods: Genomic and clinical data from the InterGEN cohort (n = 227) were used. Age acceleration was based on the Horvath method of DNA methylation (DNAm) age estimation. Accordingly, DNAm age acceleration (DNAm AA) was defined as the residuals from a linear regression of DNAm age on chronological age. Spearman’s correlations, linear and logistic regression examined associations between DNAm AA, depressive symptoms, and CM traits. Results: DNAm AA did not associate with total depressive symptom scores. DNAm AA correlated with specific symptoms including self-disgust/self-hate (−0.13, 95% CI −0.26, −0.01); difficulty with making decisions (−0.15, 95% CI −0.28, −0.02); and worry over physical health (0.15, 95% CI 0.02, 0.28), but were not statistically significant after multiple comparison correction. DNAm AA associated with obesity (0.08, 95% CI 1.02, 1.16), hypertension (0.08, 95% CI 1.01, 1.17), and DM (0.20, 95% CI 1.09, 1.40), after adjustment for potential confounders. Conclusions: Associations between age acceleration and depressive symptoms may be highly nuanced and dependent on study design contexts. Factors other than age acceleration may explain the connection between depressive symptoms and CM traits. AAW with CM traits may be at increased risk of accelerated aging.

Gut Microbiota and Depressive Symptoms at the End of CRT for Rectal Cancer: A Cross-Sectional Pilot Study

Gonzalez-Mercado, V. J., Lim, J., Saligan, L. N., Perez, N., Rodriguez, C., Bernabe, R., Ozorio, S., Pedro, E., Sepehri, F., & Aouizerat, B. (2021). Depression Research and Treatment, 2021. 10.1155/2021/7967552
Abstract
Abstract
Background. The role of alterations in gut microbiota composition (termed dysbiosis) has been implicated in the pathobiology of depressive symptoms; however, evidence remains limited. This cross-sectional pilot study is aimed at exploring whether depressive symptom scores changed during neoadjuvant chemotherapy and radiation therapy to treat rectal cancer, and if gut microbial taxa abundances and predicted functional pathways correlate with depressive symptoms at the end of chemotherapy and radiation therapy. Methods. 40 newly diagnosed rectal cancer patients (ages 28-81; 23 males) were assessed for depressive symptoms using the Hamilton Rating Scale for Depression (HAM-D) and provided stool samples for 16S rRNA sequencing. Gut microbiome data were analyzed using QIIME2, and correlations and regression analyses were performed in R. Results. Participants had significantly higher depressive symptoms at the end as compared to before CRT. The relative abundances of Gemella, Bacillales Family XI, Actinomyces, Streptococcus, Lactococcus, Weissella, and Leuconostocaceae were positively correlated (Spearman’s rho=0.42 to 0.32), while Coprobacter, Intestinibacter, Intestimonas, Lachnospiraceae, Phascolarctobacterium, Ruminiclostridium, Ruminococcaceae (UCG-005 and uncultured), Tyzzerella, and Parasutterella (Spearman’s rho=−0.43 to−0.31) were negatively correlated with HAM-D scores. Of the 14 predicted MetaCyc pathways that correlated with depressive symptom scores at the end of CRT, 11 (79%) were associated with biosynthetic pathways. Conclusions. Significant bacterial taxa and predicted functional pathways correlated with depressive symptoms at the end of chemotherapy and radiation therapy for rectal cancer which warrants further examination and replication of our findings.

Inequities along the Depression Care Cascade in African American Women: An Integrative Review

Perez, N. B., Lanier, Y., & Squires, A. (2021). Issues in Mental Health Nursing, 42(8), 720-729. 10.1080/01612840.2020.1853289
Abstract
Abstract
Depression represents a growing health problem and African American women (AAW) disproportionally experience increased risk and broad disparities in health care. This integrative review examines what is known about the equity of depression care provided to AAW. PubMed, PsychINFO, and Web of Science were searched through April 2020 for studies in peer-reviewed journals from 2015 to 2020. Across the studies (n = 7), AAW received inequitable care across a depression care cascade including lower rates of screening, treatment initiation, and guideline-concordant care. Here we explore individual-, relational-, and structural-level factors related to these disparities and implications for research, practice, and education.

A Microbial Relationship Between Irritable Bowel Syndrome and Depressive Symptoms

Perez, N. B., Wright, F., & Vorderstrasse, A. (2021). Biological Research for Nursing, 23(1), 50-64. 10.1177/1099800420940787
Abstract
Abstract
Irritable bowel syndrome (IBS) is associated with depressive symptoms, but this relationship is poorly understood. Emerging research suggests that gut microbes are associated with symptoms in persons with IBS. The purpose of this integrative review is to describe the state of the science of the microbial relationship between IBS and depressive symptoms. PubMed, CINAHL, PsychINFO, and Web of Science were searched using “irritable bowel syndrome,” “microbiome,” “depression,” and related terms. Included articles were published in peer reviewed journals in English from 2009 to 2018. Studies on inflammatory bowel conditions, extra-intestinal microbiomes, or animal models were excluded. Fourteen quantitative studies met inclusion criteria, were critically appraised, and were analyzed using the Whittemore and Knafl method. Analysis revealed a consistently lower microbial biodiversity and lower proportions of Bifidobacterium and Lactobacillus in persons with IBS and co-occurring depressive symptoms. Inclusion of participants with moderate or greater depressive symptoms scores distinguished the studies which reported microbe differences in depressive symptoms. The results of this integrative review underscore the need for studies with larger samples and inclusion of a larger range of depressive symptoms guided by an overarching conceptual framework, such as the biopsychosocial ecology framework. This effort needs to be combined with longitudinal designs in order to identify related microbial markers.