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1.
J Neural Transm (Vienna) ; 131(7): 833-845, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38693463

RESUMO

BACKGROUND: Psychotic major depression (PMD) is characterized by major depressive disorder (MDD) accompanied by delusions or hallucinations. While the prevalence of PMD and its association with anxiety have been studied, gender-specific differences and the role of thyroid hormones in PMD-related anxiety remain less explored. METHODS: A total of 1718 first-episode and drug-naïve MDD patients was assessed for the presence of PMD and severe anxiety. Clinical assessments, including Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale (PANSS), and Clinical Global Impressions-Severity (CGI-S) scale, were conducted to assess depression, anxiety, psychotic symptoms, and clinical severity, respectively. Blood samples were collected to measure thyroid function parameters. RESULTS: The prevalence of severe anxiety was higher in PMD patients compared to non-psychotic MDD patients (71.3% vs. 5.3%). No significant gender differences were observed in the prevalence of severe anxiety among PMD patients. However, elevated thyroid-stimulating hormone (TSH) levels and increased depression severity (HAMD scores) were identified as independent risk factors for severe anxiety in female PMD patients. In contrast, no significant risk factors were found in male PMD patients. The area under the receiver operating characteristic (AUCROC) analysis revealed that the HAMD score and TSH level showed acceptable discriminatory capacity for distinguishing between female PMD patients with and without severe anxiety. CONCLUSION: This study highlights the heightened prevalence of severe anxiety in PMD patients, with TSH levels and depression severity emerging as gender-specific risk factors for anxiety in females. These findings suggest the importance of thyroid hormone assessment and tailored interventions for managing anxiety in female PMD patients.


Assuntos
Ansiedade , Transtorno Depressivo Maior , Humanos , Feminino , Masculino , Adulto , Transtorno Depressivo Maior/sangue , Transtorno Depressivo Maior/epidemiologia , Pessoa de Meia-Idade , Fatores Sexuais , Ansiedade/epidemiologia , Ansiedade/sangue , Hormônios Tireóideos/sangue , Índice de Gravidade de Doença , Transtornos Psicóticos/sangue , Transtornos Psicóticos/epidemiologia , Adulto Jovem , Caracteres Sexuais , Tireotropina/sangue
2.
BMC Psychiatry ; 24(1): 210, 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38500067

RESUMO

BACKGROUND: Current research has been focusing on non-suicidal self-injury (NSSI) behaviors among adolescents with depression. Although family intimacy and adaptability are considered protective factors for NSSI, evidence supporting this relationship is lacking. OBJECTIVE: This study aims to examine the mechanisms operating in the relationship between family intimacy and adaptability and NSSI behaviors among adolescents. METHODS: A self-administered general demographic information questionnaire, the Behavioral Functional Assessment Scale for Non-Suicidal Self-Injury, the Family Intimacy and Adaptability Scale, the Connor-Davidson Resilience Scale, and the Self-Assessment of Depression Scale were distributed among adolescents with depression in three tertiary hospitals in Jiangsu Province. RESULTS: The relationship between family intimacy and adaptability and NSSI was assessed among 596 adolescents with depression. The results revealed the following: (1) Family intimacy and adaptability were negatively correlated with NSSI behavior. (2) Psychological resilience and depression levels acted as chain mediators in the relationship between family intimacy and adaptability and NSSI behavior. CONCLUSIONS: Enhancing psychological resilience, controlling depressive symptoms, and reducing depression severity among adolescents by improving their family intimacy and adaptability are conducive to preventing and mitigating their NSSI behaviors.


Assuntos
Resiliência Psicológica , Comportamento Autodestrutivo , Adolescente , Humanos , Análise de Mediação , Comportamento Autodestrutivo/psicologia , Testes Psicológicos
3.
BMC Psychiatry ; 23(1): 938, 2023 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-38093196

RESUMO

BACKGROUND: This study included evaluation of the effectiveness of vortioxetine, a treatment for adults with major depressive disorder (MDD), using patient-reported outcome measures (PROMs) in a real-world setting. METHODS: This retrospective chart review analyzed the care experiences of adult patients with a diagnosis of MDD from Parkview Physicians Group - Mind-Body Medicine, Midwestern United States. Patients with a prescription for vortioxetine, an initial baseline visit, and ≥ 2 follow-up visits within 16 weeks from September 2014 to December 2018 were included. The primary outcome measure was effectiveness of vortioxetine on depression severity as assessed by change in Patient Health Questionnaire-9 (PHQ-9) scores ~ 12 weeks after initiation of vortioxetine. Secondary outcomes included changes in depression-related symptoms (i.e., sexual dysfunction, sleep disturbance, cognitive function, work/social function), clinical characteristics, response, remission, and medication persistence. Clinical narrative notes were also analyzed to examine sleep disturbance, sexual dysfunction, appetite, absenteeism, and presenteeism. All outcomes were examined at index (start of vortioxetine) and at ~ 12 weeks, and mean differences were analyzed using pairwise t tests. RESULTS: A total of 1242 patients with MDD met inclusion criteria, and 63.9% of these patients had ≥ 3 psychiatric diagnoses and 65.9% were taking ≥ 3 medications. PHQ-9 mean scores decreased significantly from baseline to week 12 (14.15 ± 5.8 to 9.62 ± 6.03, respectively; p < 0.001). At week 12, the response and remission rates in all patients were 31.0% and 23.1%, respectively, and 67% continued vortioxetine treatment. Overall, results also showed significant improvements by week 12 in anxiety (p < 0.001), sexual dysfunction (p < 0.01), sleep disturbance (p < 0.01), cognitive function (p < 0.001), work/social functioning (p = 0.021), and appetite (p < 0.001). A significant decrease in presenteeism was observed at week 12 (p < 0.001); however, no significant change was observed in absenteeism (p = 0.466). CONCLUSIONS: Using PROMs, our study results suggest that adults with MDD prescribed vortioxetine showed improvement in depressive symptoms in the context of a real-world clinical practice setting. These patients had multiple comorbid psychiatric and physical diagnoses and multiple previous antidepressant treatments had failed.


Assuntos
Transtorno Depressivo Maior , Disfunções Sexuais Fisiológicas , Adulto , Humanos , Vortioxetina/uso terapêutico , Transtorno Depressivo Maior/psicologia , Estudos Retrospectivos , Antidepressivos/uso terapêutico , Resultado do Tratamento , Método Duplo-Cego
4.
Eur Child Adolesc Psychiatry ; 31(5): 729-736, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-33432401

RESUMO

Adults with major depressive disorder (MDD) with psychotic features (delusions and/or hallucinations) have more severe symptoms and a worse prognosis. Subclinical psychotic symptoms are more common in adolescents than adults. However, the effects of psychotic symptoms on outcome of depressive symptoms have not been well studied in adolescents. Depressed adolescents aged 11-17 with and without psychotic symptoms were compared on depression severity scores at baseline and at 28- or 42-week follow-up in two large UK cohorts. Psychotic symptoms were weakly associated with more severe depression at baseline in both cohorts. At follow-up, baseline psychotic symptoms were only associated with depressive symptoms in one sample; in the other, the effect size was close to zero. This supports the DSM5 system of psychotic symptoms being a separate code to severity rather than the ICD10 system which only allows the diagnosis of psychotic depression with severe depression. There was no clear support for psychotic symptoms being a baseline marker of treatment response.


Assuntos
Transtorno Depressivo Maior , Transtornos Psicóticos , Adolescente , Adulto , Estudos Transversais , Depressão , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Alucinações , Humanos , Transtornos Psicóticos/complicações , Transtornos Psicóticos/diagnóstico
5.
J Geriatr Psychiatry Neurol ; 34(1): 21-28, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32036772

RESUMO

OBJECTIVE: Apathy symptoms are defined as a lack of interest and motivation. Patients with late-life depression (LLD) also suffer from lack of interest and motivation and previous studies have linked apathy to vascular white matter hyperintensities (WMH) of the brain in depressed and nondepressed patients. The aim of this study was to investigate the relationship between apathy symptoms, depressive symptoms, and WMH in LLD. We hypothesize that late-onset depression (LOD; first episode of depression after 55 years of age) is associated with WMH and apathy symptoms. METHODS: Apathy scores were collected for 87 inpatients diagnosed with LLD. Eighty patients underwent brain magnetic resonance imaging. Associations between depressive and apathy symptoms and WMH were analyzed using linear regression. RESULTS: All 3 subdomains of the 10-item Montgomery-Åsberg Depression Rating Scale correlated significantly with the apathy scale score (all P < .05). In the total sample, apathy nor depressive symptoms were related to specific WMH. In LOD only, periventricular WMH were associated with depression severity (ß = 5.21, P = .04), while WMH in the left infratentorial region were associated with apathy symptoms (ß coefficient = 5.89, P = .03). CONCLUSION: Apathy and depressive symptoms are highly overlapping in the current cohort of older patients with severe LLD, leading to the hypothesis that apathy symptoms are part of depressive symptoms in the symptom profile of older patients with severe LLD. Neither apathy nor depressive symptoms were related to WMH, suggesting that radiological markers of cerebrovascular disease, such as WMH, may not be useful in predicting these symptoms in severe LLD.


Assuntos
Apatia , Depressão/patologia , Imageamento por Ressonância Magnética/métodos , Qualidade de Vida , Substância Branca/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Encéfalo/irrigação sanguínea , Encéfalo/patologia , Depressão/epidemiologia , Transtorno Depressivo/patologia , Avaliação Geriátrica , Humanos , Transtornos de Início Tardio , Masculino , Pessoa de Meia-Idade , Neuroimagem , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Substância Branca/irrigação sanguínea , Substância Branca/patologia
6.
Epilepsy Behav ; 125: 108448, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34839245

RESUMO

OBJECTIVE: To determine whether and the extent to which depression severity mediates the impact of perceived stigma on quality of life in patients with epilepsy (PWE). METHODS: A consecutive cohort of 165 PWE was invited to participate in this study. Each participant completed the Kilifi Stigma Scale of Epilepsy (KSSE), Depression Inventory for Epilepsy (NDDI-E), and Quality of Life in Epilepsy Inventory (QOLIE-31). Mediation analysis was employed to assess whether depression severity mediates the relationship between perceived stigma and quality of life. RESULTS: Perceived stigma was positively associated with depression severity and negatively associated with quality of life in PWE. The mediation analysis confirmed that perceived stigma had an indirect effect on the quality of life through the mediating variable of depression severity in PWE (B = -0.576, SE = 0.097, Bootstrap95% CI = -0.784 to -0.405). The indirect effects of perceived stigma on quality of life through depression severity accounted for 57.7% of the total effects of perceived stigma on quality of life. CONCLUSION: This study provided evidence that depression severity mediates the impact that perceived stigma has on quality of life, indicating that assessment of and interventions targeting depression may be appropriate for PWE.


Assuntos
Epilepsia , Qualidade de Vida , Estudos de Coortes , Depressão/etiologia , Humanos , Estigma Social
7.
Medicina (Kaunas) ; 57(5)2021 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-34066782

RESUMO

Background and Objectives: Affective disorders, namely bipolar (BDs) and depressive disorders (DDs) are characterized by high prevalence and functional impairment. From a dimensional point of view, BDs and DDs can be considered as psychopathological entities lying on a continuum. A delay in treatment initiation might increase the burden associated with affective disorders. The aim of this study is to analyze the correlates of a long duration of untreated illness (DUI) in these conditions. Materials and Methods: Subjects with BDs and DDs, both in- and outpatients, were recruited. Long DUI was defined according to previous research criteria as >2 years for BDs or >1 year for DDs. Socio-demographic, clinical and psychopathological characteristics of the recruited subjects were collected. Bivariate analyses were performed to compare subjects with a long and short DUI (p < 0.05). Results: In our sample (n = 61), 34.4% of subjects presented a long DUI. A long DUI was significantly associated with longer overall illness duration (p = 0.022) and a higher rate of psychiatric (p = 0.048) and physical comorbidities (p = 0.023). As for psychopathological features, depressive symptoms were more severe in the long DUI subgroup, as demonstrated by a higher score at the Clinical Global Impression-severity of depression (p = 0.012) item and at the anxiety/depression factor of the Positive and Negative Syndrome Scale (p = 0.041). Furthermore, subjects with a long DUI displayed more severe disruption of circadian rhythms, as evaluated by the Biological Rhythms Interview for Assessment in Neuropsychiatry total (p = 0.044) and social domain (p = 0.005) scores and by the Hamilton Depression Rating Scale diurnal variation items (18a: p = 0.029, 18b: p = 0.047). Conclusions: A long DUI may underpin higher clinical severity, as well as worse illness course and unfavorable prognosis in affective disorders. Intervention strategies targeting comorbidities, depressive symptoms and circadian rhythms may decrease disease burden in subjects with a long DUI.


Assuntos
Ritmo Circadiano , Depressão , Comorbidade , Depressão/epidemiologia , Humanos , Transtornos do Humor/epidemiologia , Fatores de Tempo
8.
Sensors (Basel) ; 20(18)2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899881

RESUMO

Recently, the relationship between emotional arousal and depression has been studied. Focusing on this relationship, we first developed an arousal level voice index (ALVI) to measure arousal levels using the Interactive Emotional Dyadic Motion Capture database. Then, we calculated ALVI from the voices of depressed patients from two hospitals (Ginza Taimei Clinic (H1) and National Defense Medical College hospital (H2)) and compared them with the severity of depression as measured by the Hamilton Rating Scale for Depression (HAM-D). Depending on the HAM-D score, the datasets were classified into a no depression (HAM-D < 8) and a depression group (HAM-D ≥ 8) for each hospital. A comparison of the mean ALVI between the groups was performed using the Wilcoxon rank-sum test and a significant difference at the level of 10% (p = 0.094) at H1 and 1% (p = 0.0038) at H2 was determined. The area under the curve (AUC) of the receiver operating characteristic was 0.66 when categorizing between the two groups for H1, and the AUC for H2 was 0.70. The relationship between arousal level and depression severity was indirectly suggested via the ALVI.


Assuntos
Nível de Alerta , Transtorno Depressivo Maior , Reconhecimento de Voz , Adulto , Idoso , Depressão/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Adulto Jovem
9.
J Ment Health ; 29(2): 182-190, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31373519

RESUMO

Background: Stigma is one of several barriers to seeking mental health care. However, few studies have examined how stigma relates to other common barriers (e.g. attitudes about treatment, cost, time).Aims: This study investigated whether depression stigma (internalized or perceived) was related to other treatment-seeking barriers (attitudinal, structural) and whether depression severity influenced the strength of the association.Methods: We used multivariable-adjusted linear regression to model barrier outcomes as a function of internalized and perceived stigma in an undergraduate population (N = 2551). We evaluated potential effect modification by depression severity using likelihood-ratio tests.Results: Internalized stigma displayed a stronger association with overall barriers to care (including perceived need, negative treatment expectations, and structural barriers) than did perceived stigma. Higher internalized stigma predicted a stronger emphasis on each barrier to treatment measured. Sub-components of internalized stigma (e.g. alienation, stereotype endorsement) uniquely predicted a greater emphasis on distinct barriers.Conclusions: Internalized stigma is strongly linked to greater perception of barriers to mental health care. It may be necessary to address stigma and barriers concurrently rather than independently.


Assuntos
Depressão/prevenção & controle , Depressão/psicologia , Acessibilidade aos Serviços de Saúde , Comportamento de Busca de Ajuda , Saúde Mental , Estigma Social , Atitude Frente a Saúde , Estudos Transversais , Feminino , Humanos , Masculino
10.
Prev Med ; 112: 61-69, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29604327

RESUMO

Although commuting provides an opportunity for incorporating physical activity into daily routines, little is known about the effect of active commuting upon depressive symptoms. This study aimed to determine whether changes in commute mode are associated with differences in the severity of depressive symptoms in working adults. Commuters were selected from the UK Biobank cohort if they completed ≥2 assessment centre visits between 2006 and 2016. Modes of travel to work were self-reported at each visit. Participants were categorised as 'inactive' (car only) or 'active' commuters (any other mode(s), including walking, cycling and public transport). Transitions between categories were defined between pairs of visits. The severity of depressive symptoms was defined using the two-item Patient Health Questionnaire (PHQ-2). Scores were derived between zero and six. Higher values indicate more severe symptoms. Separate analyses were conducted in commuters who were asymptomatic (zero score) and symptomatic (non-zero score) at baseline. The analytical sample comprised 5474 participants aged 40-75 at baseline with a mean follow-up of 4.65 years. Asymptomatic commuters who transitioned from inactive to active commuting reported less severe symptoms at follow-up than those who remained inactive (ß -0.10, 95% CI [-0.20, 0.00]; N = 3145). A similar but non-significant relationship is evident among commuters with pre-existing symptoms (ß -0.60, 95% CI [-1.27, 0.08]; N = 1078). After adjusting for transition category, longer commutes at baseline were associated with worse depressive symptoms at follow-up among symptomatic participants. Shifting from exclusive car use towards more active commuting may help prevent and attenuate depressive symptoms in working adults.


Assuntos
Depressão/epidemiologia , Índice de Gravidade de Doença , Meios de Transporte/métodos , Meios de Transporte/estatística & dados numéricos , Adulto , Idoso , Ciclismo/estatística & dados numéricos , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Reino Unido/epidemiologia , Caminhada/estatística & dados numéricos
11.
Cell Physiol Biochem ; 41(4): 1393-1402, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28494456

RESUMO

OBJECTIVE: To study the metabolic changes of cerebellum by proton magnetic resonance Spectroscopy (1H-MRS) and discuss the relationships between the cerebellar changes and depression severity in patients with post-stroke depression. METHODS AND RESULTS: Data of demographic characteristics, individual history and life style of all subjects were collected. 40 patients with stroke and 20 controls were enrolled. All groups received T1WI, T2WI, DWI and 1H-MRS examination. The cerebral infarction volume and the distribution and severity of leukoaraiosis were evaluated. The ratios of NAA/Cr, Cho/Cr and Cho/NAA in the cerebellum were calculated. There were no statistical significant difference in the NAA/Cr, Cho/Cr and Cho/NAA ratios in bilateral cerebellum between CONT group and NORM group. The Cho/Cr and Cho/NAA ratios in the cerebellum contralateral to the stroke region were higher in PSD group than those in NORM and CONT groups, and the Cho/Cr and Cho/NAA ratios in the cerebellum ipsilateral to the stroke region were similar with those in NORM and CONT groups. However, there were no statistical significant difference in the NAA/Cr ratios in bilateral cerebellum among three groups. CONCLUSION: The result shows preliminarily that the cerebellum involves in the development of post-stroke depression.


Assuntos
Cerebelo , Depressão , Espectroscopia de Prótons por Ressonância Magnética , Acidente Vascular Cerebral , Idoso , Cerebelo/diagnóstico por imagem , Cerebelo/metabolismo , Depressão/diagnóstico por imagem , Depressão/etiologia , Depressão/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/metabolismo
12.
Qual Life Res ; 26(9): 2459-2469, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28503714

RESUMO

PURPOSE: Cognitive impairment is a core feature of major depressive disorder (MDD), and dysfunctions in this area strongly contribute to MDD-associated disability. Whether cognitive impairment has an independent clinical course and a unique impact on HRQOL is still debated. We sought to characterize the relationship between depression severity and HRQOL, evaluating the burden of concentration difficulties on HRQOL. METHODS: Six hundred ninety-two patients with unipolar depressive disorders recruited in 19 Italian centers answered a self-administered survey (SF-12 questionnaire, socio-demographic information). A psychiatrist completed a standardized data collection form encompassing a depression severity scale (MADRS) and clinical information. RESULTS: There was a strong graded association between the severity of depressive symptoms and both the physical (ω 2 = 0.13; p < 0.01) and mental (ω 2 = 0.34; p < 0.01) SF-12 domains. Additionally, we observed a strong association between concentration difficulties and all HRQOL outcomes independent of other symptoms of depression and robust to adjustment for possible confounders. CONCLUSIONS: Our data corroborate previous findings suggesting that cognitive impairment is a feature of unipolar depressive disorders partially independent of the severity of other symptoms, and may represent a specific target of therapy with a strong impact on patients' functioning and quality of life.


Assuntos
Depressão/psicologia , Qualidade de Vida/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
13.
J Dual Diagn ; 13(4): 305-311, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28820669

RESUMO

OBJECTIVE: The purpose of this study was to test the initial psychometric properties of the 17-item Hamilton Depression Rating Scale (HAM-D) in individuals with and without major depressive disorder who use methamphetamine. We used data from two completed studies and two ongoing clinical trials. The HAM-D has well established reliability and validity in a variety of populations. However, there are no published reports of reliability and validity of the HAM-D in a methamphetamine-using population. METHODS: HAM-D and depression status data were extracted from four separate studies for this psychometric assessment. Using these data, we evaluated three measures of construct validity: internal consistency, contrasted group validity, and factorial validity. RESULTS: We found potential concerns with the construct validity of the HAM-D in users of methamphetamine. Intercorrelations between items were primarily less than 0.20 and the Cronbach's alpha value in this sample was 0.58, indicating potential issues with internal consistency. The results of two-sample t-tests suggest concerns with contrasted group validity, as no significant difference in average scores were found for nine items. Consistent with previous studies, a principal component analysis indicates that the HAM-D is multidimensional. CONCLUSIONS: The 17-item HAM-D might not reliably and validly measure depression severity in a methamphetamine-using population. Given our small sample, additional research is needed, though, to further test the psychometric properties of the HAM-D in individuals who use methamphetamine.


Assuntos
Transtornos Relacionados ao Uso de Anfetaminas/complicações , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico , Escalas de Graduação Psiquiátrica , Adulto , Transtornos Relacionados ao Uso de Anfetaminas/diagnóstico , Estimulantes do Sistema Nervoso Central/administração & dosagem , Diagnóstico Duplo (Psiquiatria) , Análise Fatorial , Feminino , Humanos , Masculino , Metanfetamina/administração & dosagem , Dados Preliminares , Análise de Componente Principal , Psicometria , Reprodutibilidade dos Testes , Índice de Gravidade de Doença
14.
Depress Anxiety ; 33(6): 483-94, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26882201

RESUMO

BACKGROUND: Suicidal thoughts and behaviors could be associated to a poor response to antidepressant treatment, but the exclusion of suicidal patients from randomized clinical trials restricts the available knowledge. In this study, we aimed at defining more precisely the response to antidepressants among suicidal patients and the threshold of suicidality that best predicts a poor response. METHOD: We investigated the short-term response to a new antidepressant treatment of 4,041 depressed outpatients depending on their suicidal status (passive or active suicidal ideation (SI), history of suicide attempts [SAs]), either self-rated or clinician-rated. Depression outcomes, measured with the Hospital Anxiety and Depression Scale, and remission rates were compared depending on suicidal status at baseline using logistic regression models. RESULTS: Using either a qualitative or a quantitative approach to measure SI, we found that suicidal patients were less likely to improve or attain remission, but not more likely to worsen, than nonsuicidal patients. In the multivariate analyses, SI (odds ratio [OR] = 1.40; 95% confidence interval [CI]: 1.18-1.65) and a history of SA (OR = 1.39; 95% CI: 1.16-1.66) were the best predictors of nonremission, independently of the class of antidepressant treatment. CONCLUSION: Antidepressant treatment seems to be less effective among those patients that need it most. Clinical trials including suicidal patients are needed to investigate specific treatment options.


Assuntos
Antidepressivos/farmacologia , Transtorno Depressivo/tratamento farmacológico , Avaliação de Resultados em Cuidados de Saúde , Ideação Suicida , Tentativa de Suicídio , Adulto , Feminino , Humanos , Masculino
15.
Memory ; 24(10): 1302-10, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-26494540

RESUMO

Overgeneral memory (OGM), the tendency to retrieve categories of events from autobiographical memory instead of single events, is found to be a reliable predictor for future mood disturbances and post-traumatic symptom severity. Patients with borderline personality disorder (BPD) often report co-morbid episodes of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). Therefore, we investigated whether OGM would predict depression severity and (post-traumatic) stress symptoms in BPD patients. At admission (N = 54) and at six-month follow-up (N ≥ 31), BPD patients completed the Structured Clinical Interview for DSM-IV Disorders, the Assessment of DSM-IV Personality Disorders, the Autobiographical Memory Test, the Beck Depression Inventory-2nd edition (BDI-II), and the Impact of Event Scale. OGM at baseline predicted (a) higher levels of depressive symptoms at follow-up and (b) more intrusions related to a stressful event over and above baseline levels of borderline symptoms, depressive symptoms, and intrusions, respectively. No association was found between memory specificity and event-related avoidance at follow-up. Despite previous findings suggesting that OGM in BPD is less robust than in MDD and PTSD, our results suggest that memory specificity in BPD patients may have some relevance for the course of depressive and stress symptomatology in BPD.


Assuntos
Transtorno da Personalidade Borderline/psicologia , Depressão/psicologia , Memória Episódica , Adulto , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Determinação da Personalidade , Adulto Jovem
16.
Sci Rep ; 14(1): 16328, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39009760

RESUMO

This study employs machine learning to detect the severity of major depressive disorder (MDD) through binary and multiclass classifications. We compared models that used only biomarkers of oxidative stress with those that incorporate sociodemographic and health-related factors. Data collected from 830 participants, based on the Patient Health Questionnaire (PHQ-9) score, inform our analysis. In binary classification, the Random Forest (RF) classifier achieved the highest Area Under the Curve (AUC) of 0.84 when all features were included. In multiclass classification, the AUC improved from 0.84 with only oxidative stress biomarkers to 0.88 when all characteristics were included. To address data imbalance, weighted classifiers, and Synthetic Minority Over-sampling Technique (SMOTE) approaches were applied. Weighted random forest (WRF) improved multiclass classification, achieving an AUC of 0.91. Statistical tests, including the Friedman test and the Conover post-hoc test, confirmed significant differences between model performances, with WRF using all features outperforming others. Feature importance analysis shows that oxidative stress biomarkers, particularly GSH, are top ranked among all features. Clinicians can leverage the results of this study to improve their decision-making processes by incorporating oxidative stress biomarkers in addition to the standard criteria for depression diagnosis.


Assuntos
Biomarcadores , Transtorno Depressivo Maior , Aprendizado de Máquina , Estresse Oxidativo , Humanos , Feminino , Transtorno Depressivo Maior/diagnóstico , Masculino , Adulto , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Área Sob a Curva , Depressão/diagnóstico , Algoritmo Florestas Aleatórias
17.
J Affect Disord ; 350: 521-530, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38237870

RESUMO

BACKGROUND: Previous studies proposed that functional near-infrared spectroscopy (fNIRS) can be used to distinguish between not only different severities of depressive symptoms but also different subgroups of depression, such as anxious and non-anxious depression, bipolar and unipolar depression, and melancholia and non-melancholia depression. However, the differences in brain haemodynamic activation between depression subgroups (such as confirmed depression [CD] and suspected depression [SD]) with different symptom severities and the possible correlation between symptom severity and haemodynamic activation in specific brain regions using fNIRS have yet to be clarified. METHODS: The severity of depression symptoms was classified using the Hospital Anxiety and Depression scale (HADS) and the Mini International Neuropsychiatric Interview by psychiatrists. We recruited 654 patients with depression who had varying severities of depressive symptoms, including 276 with SD and 378 with CD, and 317 with HCs from among Chinese college students. The 53-channel fNIRS was used to detect the cerebral hemodynamic difference of the three groups during the VFT (verbal fluency task). RESULTS: Compared with the HC, region-specific fNIRS leads indicate CD patients had significant lower haemodynamic activation in three particular prefrontal regions: 1) right dorsolateral prefrontal cortex (DLPFC), 2) bilateral frontopolar cortex (FPC), and 3) right Broca's area (BA). SD vs. HC comparisons revealed only significant lower haemodynamic activation in the right FPC area. Compared to SD patients, CD patients exhibited decreased hemodynamic activation changes in the right DLPFC and the right BA. Correlation analysis established a significant negative correlation between the hemodynamic changes in the bilateral FPC and the severity of depressive symptoms. CONCLUSIONS: The right DLPFC and right BA are expected to be physiological mechanisms to distinguish depression subgroups (CD, SD) with different symptom severities. The haemodynamic changes in the bilateral FPC was nagatively associated with the symptom severity of depression.


Assuntos
Depressão , Transtorno Depressivo , Humanos , Depressão/diagnóstico por imagem , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Córtex Pré-Frontal/diagnóstico por imagem , Transtorno Depressivo/diagnóstico por imagem , Área de Broca
18.
J Affect Disord ; 356: 477-482, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38653159

RESUMO

BACKGROUND: The prevalence of depressive disorder is increasing due to a variety of factors, which brings a huge strain on individuals, families and society. This study aims to investigate whether there is Frontal Theta Asymmetry (FTA) in depressed patients, and whether FTAs are related to depression severity and cognitive function changes in depressed patients. METHODS: Participants who met the inclusion criteria were enrolled in this study. Socio-demographic data of each participant were recorded. Zung's self-rating Depression Scale was used to assess the depression status of participants. P300 was used to evaluate the cognitive function of participants. EEG data from participants were collected by the NeuroScan SynAmps RT EEG system. t-test, Wilcoxon rank-sum test and Chi-square test were used to detect the differences of different variables between the two groups. Multiple linear regression analysis and multiple logistic regression analysis were used to analyze relationships between FTAs in different regions and participants' depression status and cognitive function. RESULTS: A total of 66 depressed participants and 47 healthy control participants were included in this study. The theta spectral power of the left frontal lobe was slightly stronger than that of the right frontal lobe in the depression group, while the opposite was true in the healthy control group. The FTA in F3/F4 had certain effects on the emergence of depression in participants, the emergence of depression in participants and Changes in cognitive function. CONCLUSIONS: FTAs are helpful to assess the severity of depression and early identify cognitive impairment in patients with depression.


Assuntos
Cognição , Eletroencefalografia , Lobo Frontal , Ritmo Teta , Humanos , Masculino , Feminino , Ritmo Teta/fisiologia , Adulto , Lobo Frontal/fisiopatologia , Cognição/fisiologia , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Depressão/fisiopatologia , Depressão/psicologia , Escalas de Graduação Psiquiátrica , Transtorno Depressivo/fisiopatologia , Potenciais Evocados P300/fisiologia , Disfunção Cognitiva/fisiopatologia
19.
J Affect Disord ; 352: 473-478, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38401808

RESUMO

BACKGROUND: Access to healthcare is essential for managing chronic diseases, yet it often poses a barrier, contributing to a significant burden of conditions like depression. This study aimed to investigate the association between healthcare access and depression severity in contemporary free-living adults in the US, with a focus on identifying vulnerable populations. METHOD: Data from the National Health and Nutrition Examination Survey cycles 2013-2018 were utilized, involving 13,689 participants aged 20 years or older. Multivariable multinomial logistic regression models were conducted, adjusting for various confounding variables. RESULTS: Approximately 17 % of US adults lacked access to healthcare, while 24 % experienced varying levels of depression severity, with 8 % having moderate-to-severe depression. More males faced challenges accessing healthcare, while more females reported diverse levels of depression. Both healthcare access and depression severity were associated with low educational attainment, low familial income, lacking spousal support, lacking health insurance coverage, and worse self-reported overall health. We found a higher vulnerability to moderate-to-severe depression among females (OR (95 % CI): 1.20 (0.91, 1.59)), individuals identifying as the Other ethnic group (1.69 (1.02, 2.79)), and those living without a spouse (1.57 (1.10, 2.26)). LIMITATIONS: Our cross-sectional study cannot establish causality, and potential biases related to self-reported data exist. CONCLUSIONS: Access to healthcare emerged as a crucial predictor of moderate-to-severe depression among females, individuals of the Other ethnic group, and those without a spouse. Longitudinal research is needed to confirm and enhance our understanding of factors that shape the relationship between healthcare access and depression in free-living US adults.


Assuntos
Depressão , Transtorno Depressivo , Adulto , Masculino , Feminino , Humanos , Inquéritos Nutricionais , Depressão/epidemiologia , Estudos Transversais , Acessibilidade aos Serviços de Saúde
20.
Clin EEG Neurosci ; 55(2): 185-191, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36945785

RESUMO

Background. Depression disorder has been associated with altered oscillatory brain activity. The common methods to quantify oscillatory activity are Fourier and wavelet transforms. Both methods have difficulties distinguishing synchronized oscillatory activity from nonrhythmic and large-amplitude artifacts. Here we proposed a method called self-synchronization index (SSI) to quantify synchronized oscillatory activities in neural data. The method considers temporal characteristics of neural oscillations, amplitude, and cycles, to estimate the synchronization value for a specific frequency band. Method. The recorded electroencephalography (EEG) data of 45 depressed and 55 healthy individuals were used. The SSI method was applied to each EEG electrode filtered in the alpha frequency band (8-13 Hz). The multiple linear regression model was used to predict depression severity (Beck Depression Inventory-II scores) using alpha SSI values. Results. Patients with severe depression showed a lower alpha SSI than those with moderate depression and healthy controls in all brain regions. Moreover, the alpha SSI values negatively correlated with depression severity in all brain regions. The regression model showed a significant performance of depression severity prediction using alpha SSI. Conclusion. The findings support the SSI measure as a powerful tool for quantifying synchronous oscillatory activity. The data examined in this article support the idea that there is a strong link between the synchronization of alpha oscillatory neural activities and the level of depression. These findings yielded an objective and quantitative depression severity prediction.


Assuntos
Transtorno Depressivo , Eletroencefalografia , Humanos , Eletroencefalografia/métodos , Encéfalo
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