Nicole Beaulieu Perez

Faculty

Nicole Perez Headshot

Nicole Beaulieu Perez

PhD RN PMHNP

1 212 992 9426

433 FIRST AVENUE
NEW YORK, NY 10010
United States

Nicole Beaulieu Perez, PhD, RN, PMHNP-BC, is an Assistant Professor of Nursing at NYU Rory Meyers College of Nursing, committed to advancing precision mental health care. Her research examines the social and biological roots of depression in women with chronic conditions, particularly women living with HIV. When concurrent with HIV, depression’s lack of biomarkers and heterogeneous presentations make it easy to overlook, leading to lower quality of life and premature mortality. Perez’s interdisciplinary work integrates her expertise in clinical psychiatry, ‘omics’ (such as epigenetics and gut microbiome), and advanced statistical methods to parse distinct depression phenotypes, ultimately improving early clinical detection and developing more effective, personalized treatments.  

Currently, Perez is the principal investigator of the ReDiMMH Study, a K08 award funded by the National Institute on Minority Health and Health Disparities, where she investigates the biology (epigenetic aging, gut microbiome, neurobiology) underlying the connections between poverty, depression, and metabolic health among women with or at risk for HIV. She received the NYU P20 Center pilot award funded by the National Institute of Nursing Research, through which she identified different depressive symptom phenotypes and examined inflammatory and epigenetic biomarkers associated with depressive symptoms in women with and without HIV with type 2 diabetes. She has published extensively on the intersection of depression and chronic illnesses, issues in depression assessment, and disparities in mental health care. Her research has been featured in HuffPost, Fortune, and The Independent. 

Before joining the NYU faculty, Perez 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’s Clinical and Translational Science Institute. For over a decade, Perez has worked as a psychiatric nurse and nurse practitioner in various settings,including inpatient, outpatient, residential, and telehealth environments—experiences that fuel her ongoing dedication to transforming mental health care.  

Among her many honors, Perez has received awards from the American Psychiatric Nurses Association, the Eastern Nurses Research Society, and the Barbara Jonas Foundation as a Psychiatric Mental Health Nursing Scholar.  

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

Depression
HIV/AIDS
Health Disparities
Mental health
Omics-Epigenetics and Gut Microbiome
Precision Health
Women's health

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

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)

Heterogeneous depressive symptom trajectories among women with type 2 diabetes: findings from the Women’s Interagency HIV Study

Perez, N. B., Melkus, G. D., Fletcher, J., Allen-Watts, K., Jones, D. L., Collins, L. F., Ramirez, C., Long, A., Cohen, M. H., Merenstein, D., Wilson, T. E., Sharma, A., & Aouizerat, B. (2025). Annals of Behavioral Medicine, 59(1). 10.1093/abm/kaae080
Abstract
Abstract
Background: Depression affects 33% of women with type 2 diabetes (T2D) and leads to increased risks of premature mortality. Fluctuation and variation of depressive presentations can hinder clinical identification. Purpose: We aimed to identify and examine subgroups characterized by distinct depressive symptom trajectories among women with T2D. Methods: This retrospective analysis leveraged the Women’s Interagency HIV Study data to identify depressive symptom trajectories based on the Center for Epidemiological Studies Depression scores (2014-2019) among women with and without HIV. Descriptive statistics characterized sample demographics (eg, age, race, income), clinical indices (eg, hemoglobin A1C [HbA1c], BMI, HIV status), and psychosocial experiences (eg, discrimination, social support, anxiety, pain). We used growth mixture modeling to identify groups defined by distinct depressive symptom trajectories and parametric and non-parametric tests to examine demographic, clinical, and psychosocial differences across subgroups. Results: Among the 630 women included, the mean age was 50.4 (SD = 8.3) years, 72.4% identified as Black and non-Hispanic, and 68.2% were living with HIV. Five subgroups were identified and distinguished by severity and symptom type. Participants with lower incomes (P = .01), lower employment (P < .0001), lower social support (P = .0001), and experiences of discrimination (P < .0001) showed greater membership in threshold, moderate, and severe depressive subgroups. Subgroup membership was not associated with metabolic indices (BMI, HbA1c) or HIV status. Anxiety, pain, and loneliness (all P = .0001) were worse in subgroups with higher depressive symptoms. Conclusions: Among women with T2D, depressive symptom trajectories differ across clinical and social contexts. This study advances precision by delineating subgroups within a broad clinical category.

Social determinants of inflammatory markers linking depression and type 2 diabetes among women: A scoping review

Perez, N., He, N., Wright, F., Condon, E., Weiser, S., & Aouizerat, B. (2024). Journal of Psychosomatic Research, 184. 10.1016/j.jpsychores.2024.111831
Abstract
Abstract
Objective: Inflammation is implicated in the pathophysiology of depression and type 2 diabetes (T2D) and is linked to social determinants of health (SDoH) associated with socioeconomic disadvantage. The objective of this review is to identify and map the range of SDoHs associated with inflammation in depression, T2D, or their co-occurrence among women. Methods: PubMed, CINAHL, PsychINFO, and Web of Science were searched March–July 2023 to identify studies where 1) an SDoH was a predictor or independent variable, 2) depression or T2D was a clinical focus, 3) inflammatory markers were collected, and 4) analysis was specific to women. We used the National Institute on Minority Health and Health Disparities research framework to guide searching SDoHs, organize findings, and identify gaps. Results: Of the 1135 studies retrieved, 46 met criteria. Within the reviewed studies, the most used inflammatory measures were C-reactive protein, interleukin-6, and tumor necrosis factor-α, and the most studied SDoHs were early life stress and socioeconomic status. Individual and interpersonal-level variables comprised the bulk of SDoHs in the included studies, while few to no studies examined built environment (n = 6) or health system level (n = 0) factors. Disadvantageous SDoHs were associated with higher levels of inflammation across the included studies. Conclusion: The scope and intersection of depression and T2D represent a syndemic that contributes to and results from socioeconomic inequities and disproportionately affects women. Simultaneous inclusion of social and inflammatory measures, particularly understudied SDoHs, is needed to clarify potent targets aimed at advancing health and equity.

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. A., Yu, G., Melkus, G. D., Wright, F., Ginsberg, S. D., Crusto, C. A., Sun, Y. V., & Taylor, J. Y. (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.