Efficacy and Safety of Acupuncture in Treating Major Depressive Disorders:A Systematic Review and Meta Analysis / 世界科学技术-中医药现代化

Objective To evaluate the effectiveness and safety of acupuncture in patients with Major Depressive Disorders.Methods Search the database for relevant literature published before April 15,2023.Select randomized controlled trial that meeting the enrollment criteria,evaluate the quality of the literature and classify before meta-analysis systematic evaluation.Results 15 RCTs are included in this study,with a total of 1077 patients.The results showed that acupuncture treatment,compared with antidepressants alone,The score of Hamilton Depression Scale(HAMD)in patients with liver-qi depression disorder[MD=-0.73,95%CI(-1.22,-0.24),P<0.05],the score of TCM Syndrome Scale[MD=-1.89,95%CI(-2.35,-1.44),P<0.001],effective rate[RR=1.09,95%CI(1.03,1.153),P=0.001]and TESS score[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]were statistically significant.Compared with fluoxetine hydrochloride,the effective rate of HAMD scale score was statistically significant[RR=1.07,95%CI(1.01,1.14),P<0.05].Conclusion Compared with antidepressants alone,acupuncture therapy has the advantages for the improvement of HAMD score in patients,the improvement of Traditional Chinese medicine symptoms,and significantly less adverse effects than those in the control group.Through this study,it is considered that acupuncture can be a safe and effective treatment modality.However,due to the quantity and quality of the included literature,the above conclusions still need to be verified by more high-quality clinical trials.

Analysis of impaired vibrotactile sense in patients with schizophrenia and depressive disorders / 四川精神卫生

BackgroundPatients with schizophrenia and depressive disorders exhibit abnormalities in perceptual processing. Previous perceptual studies are mainly based on asking participants to fill in a questionnaire， and little research has been undertaken on objective behavior in patients with schizophrenia and depressive disorders. ObjectiveTo explore the behavioral changes in vibrotactile sense among patients with schizophrenia and depressive disorders， so as to enrich relevant findings in objective behavioral research. MethodsFrom March 2021 to September 2023， 33 patients with schizophrenia and 31 patients with depressive disorders in the outpatient and inpatient departments of Beijing Huilongguan Hospital and met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria were enrolled. And another 34 healthy controls were concurrently recruited at Beihang University and Beijing Huilongguan Hospital. Patients with schizophrenia were assessed using Positive and Negative Symptom Scale （PANSS）， and patients with depressive disorders were assessed using Hamilton Depression Scale-17 item （HAMD-17）. The vibrotactile sensitivity of the left hand in all participants was tested in a delay match-to-sample procedure， and the correct rate of vibrotactile delayed discrimination task was compared among the three groups. ResultsCompared with healthy controls， a reduction was found in the correct rates at index finger， middle finger and ring finger in patients with schizophrenia （P<0.01）， the average correct rate at five fingers in patients with schizophrenia （P=0.001）， and the correct rate at thumb in patients with depressive disorders （P=0.026）. No statistical difference was reported in correct rate of vibrotactile delayed discrimination task between patients with depression disorders and schizophrenia （P>0.05）. The average correct rate of vibrotactile sense in schizophrenia group was not significantly correlated with the duration of disease， age of onset， chlorpromazine equivalent doses and PANSS score （r=0.058、0.045、0.114、-0.194， P>0.05）. The average correct rate in depressive group was negatively correlated with age of onset （r=-0.415， P=0.020）， but not significantly correlated with the duration of disease and HAMD-17 score （r=-0.044， 0.142， P>0.05）. ConclusionPatients with schizophrenia and depressive disorders have impaired vibrotactile sense. The vibrotactile sense is impaired in index， middle and ring fingers among patients with schizophrenia， and in thumbs of patients with depressive disorders. Moreover， the impairment in patients with depressive disorders may be related to the age of onset. ［Funded by 2023 Hebei Provincial Graduate Innovation Funding Project （number， CXZZSS2023140）］

Is the locus of control a predictor and/or mediator of emotional dysregulation and psychopathological symptoms?

Locus of control has been highlighted as a variable related to mental health and well-being, as well as being indicated as a predictor for psychopathologies such as depression and anxiety. To verify these relationships, the aim of this study was to present two path analysis models related to the associations between locus of control, depression, anxiety, and emotional dysregulation. A sample of 327 participants (M age = 38.3 years, SD = 12.8), of both genders (Fem. = 75.2%), completed a sociodemographic questionnaire, the Locus of Control Scale (ELOCUS), the Baptista Depression Scale (EBADEP-A), the Emotional Dysregulation Scale (EDEA), and the Cognitive Anxiety Scale (ECOGA). Spearman correlations and path analyses were performed for the two proposed models. In the first model, the locus of control was a predictor of emotional dysregulation, symptoms of depression and anxiety. In the second model, the locus of control mediated the relationship between factors of emotional dysregulation (seeking strategies and pessimism) in relation to depression and anxiety. It was concluded that the locus of control is an important construct in the direct or indirect prediction of psychopathological symptoms.

El locus de control se ha señalado como una variable relacionada con la salud mental y el bienestar, además de estar indicado como un predictor de psicopatologías como la depresión y la ansiedad. Para verificar estas relaciones, el objetivo de este estudio fue presentar dos modelos de path analysis relacionados con las asociaciones entre locus de control, depresión, ansiedad y desregulación emocional. Una muestra de 327 participantes (M= 38.3 años, DE= 12.8), de ambos sexos (Fem. = 75.2 %), respondió un cuestionario sociodemográfico, la Escala de Locus de Control (ELOCUS), la Escala Baptista de Depresión (EBADEP-A), la Escala de Desregulación Emocional (EDEA) y la Escala de Ansiedad Cognitiva (ECOGA). Se realizaron correlaciones de Spearman y path analyses para los modelos propuestos. En el primer modelo, el locus de control fue un predictor de desregulación emocional, síntomas de depresión y ansiedad. En el segundo modelo, el locus de control medió la relación entre factores de desregulación emocional (búsqueda de estrategias y pesimismo) en relación con la depresión y la ansiedad. Se concluye que el locus de control es un constructo importante en la predicción directa o indirecta de síntomas psicopatológicos.

O locus de controle tem sido apontado como uma variável relacionada a saúde mental e bem-estar, além de ser indicado como um preditor para psicopatologias como depressão e ansiedade. No intuito de verificar essas relações, o objetivo deste estudo foi apresentar dois modelos de path analysis relacionados às associações entre locus de controle, depressão, ansiedade e desregulação emocional. Uma amostra de 327 participantes (M = 38,3 anos, DP = 12,8), ambos os sexos (Fem. = 75,2%), responderam um questionário sociodemográfico, a Escala de Locus de Controle (ELOCUS), a Escala Baptista de Depressão (EBADEP-A), a Escala de Desregulação Emocional (EDEA) e a Escala Cognitiva de Ansiedade (ECOGA). Foram realizadas correlações de Spearman, além de path analyses dos modelos propostos. No primeiro modelo, o locus de controle foi preditor da desregulação emocional, sintomatologia de depressão e ansiedade. Já, no segundo modelo, o locus de controle mediou a relação entre fatores da desregulação emocional (busca por estratégias e pessimismo) em relação a depressão e ansiedade. Conclui-se que o locus de controle é um construto importante na predição direta ou indireta de sintomas psicopatológicos.

Resting-state functional connectivity strength in patients with major depressive disorder / 中国神经精神疾病杂志

Objective To explore the functional connectivity characteristics and intensity of brain network in depression at rest.Methods Patients with major depressive disorder(MDD)and healthy controls(HCs)underwent resting state functional magnetic resonance imaging.The total brain degree centrality(DC)of the two groups was calculated to assess the functional connection strength.Support vector machine(SVM)method was used to investigate whether abnormal DC value can recognize MDD.Results A total of 26 patients and 37 controls were included in the analysis.Compared to HCs,MDD group showed decreased DC value in the left middle frontal gyrus(t=-4.98,P＜0.05,GRF corrected)and increased DC value in the right middle temporal gyrus(t=5.02,P＜0.05,GRF corrected),right parahippocampal gyrus(t=4.80,P＜0.05,GRF corrected),and right posterior cerebellar gyrus(t=4.98,P＜0.05,GRF corrected).Additionally,no significant correlations were found between abnormal DC values and clinical variables(i.e.,17-item Hamilton depression scale and Beck depression scale scores)in MDD group(P＞0.05).SVM analysis showed that decreased DC value in the left middle frontal gyrus might be used to distinguish MDD group from HCs with an accuracy of 84.13%,a specificity of 81.08%,and a sensitivity of 88.46%,the area under the operational characteristic curve is 0.87.Conclusions Altered DC values in the left middle frontal gyrus and right middle temporal gyrus,right parahippocampal gyrus,right posterior cerebellum may contribute to the pathophysiology of MDD.The change of functional connection strength of the left medial frontal gyrus may be helpful for the recognition of MDD.

Depressão em adultos do Brasil: custos, perfil dos atendimentos e cobertura presumida dos CAPS / Depression in adults from Brazil: costs, medical care profile and presumed coverage from CAPS

Introdução: A depressão é um transtorno incapacitante e causa prejuízos funcionais, além de altos custos para o sistema de saúde e previdência social. No Brasil, os Centros de Atenção Psicossocial são serviços de base comunitária, prioritários para o cuidado, a fim de possibilitar a reinserção social dos sujeitos adoecidos mentalmente. Objetivos: Investigar os custos diretos e indiretos da depressão no Brasil entre 2010 e 2018, e a oferta de cuidados em saúde dos CAPS a indivíduos com depressão, entre 2013-2019. Métodos: Estudo de custo da doença baseado na prevalência, com abordagem top-down, sob a perspectiva da sociedade, e estudo descritivo, ecológico, de série temporal, com dados secundários de bancos de dados nacionais, com adultos de 18 anos ou mais de idade, com diagnóstico de depressão. Foram incluídos custos diretos (hospitalares e ambulatoriais), provenientes dos Sistemas de Informação Hospitalar e Ambulatorial, e indiretos (absenteísmo), do Instituto Nacional de Seguro Social, além dos atendimentos efetuados nos CAPS, provenientes dos Registros das Ações Ambulatoriais de Saúde (RAAS psicossocial). Os custos foram calculados por ano, de 2010 a 2018. A cobertura presumida de CAPS foi calculada para 2013 e 2019, com base nos serviços cadastrados e ativos. Resultados: O custo da depressão foi de Int$ 2.288.511.607,39 no período analisado, com custo médio anual de Int$ 254.279.067,49. De 2014 a 2018, houve queda acentuada no custo da depressão (-44,24%), principalmente nos custos indiretos (-55,83%). No período investigado, os custos indiretos representaram 74,85% do custo total. Com o tempo, o ambulatório superou o custo hospitalar. Em 2017 e 2018, os custos ambulatoriais representaram, respectivamente, 43,22% e 39,57% dos custos totais. Em todos os anos analisados, predominaram os custos e atendimentos nos CAPS para o sexo feminino (77%). Houve um aumento de 107% no número de pacientes com depressão atendidos nos CAPS entre 2013 e 2019. Prevaleceram, entre os atendidos, aqueles de cor/raça branca (38%) e parda (34%), na faixa etária de 41-60 anos (49%). Foram mais frequentes o diagnóstico de episódios depressivos (65%) e o atendimento individual (75%). A cobertura presumida dos CAPS foi de 71% e 87% no país em 2013 e 2019, respectivamente, embora com disparidades acentuadas entre os estados. Conclusões: A depressão é uma doença com elevada carga econômica para o sistema de saúde. Foram identificados avanços na implementação dos CAPS no país, no período 2013-2019. No entanto, ainda são necessários investimentos, tal como maior cobertura dos serviços, pois ainda permanecem desigualdades entre as unidades federativas, além de serem reduzidos os atendimentos em grupos e familiares, sendo necessária a capacitação de equipes multiprofissionais e de profissionais de saúde aptos para a atenção psicossocial.

Introduction: Depression is a disabling disorder and it causes functional damages, in addition to high costs to the health system and social previdence. In Brazil, the Psychosocial Atention Centers are services of communitarian base intented to care and enable the social reinsertion of mentally diseased individuals. Objectives: To investigate depression's direct and indirect costs in Brazil between 2010 and 2018, and CAPS' offer of medical care to individuals with depression, between 2013-2019. Methods: Study of cost based on prevalence, with top-down approach, under the perspective of society, and descriptive, ecological study of temporal series, with secondary data from national data banks, with adults over 18 years old or more, diagnosed with depression. Direct costs (hospital and outpatient) that came from Hospital and Outpatient Information Systems and indirect ones (absenteeism) that came from the National Institute of Social Security were included, in addition to the performed medical cares in CAPS, which can be found on the Records of Outpatient Health Actions (psychosocial RAAS). The costs were calculated by year, from 2010 to 2018. CAPS' presumed coverage was calculated for 2013 and 2019, based on registered and active services. The cost of depression was from Int$ 2.288.211.607,39 in the analyzed period, with an average annual cost of Int$ 254.279.067,49. From 2014 to 2018, there was an elevated decrease in the cost of depression (-44,24%), mainly in indirect costs (-55,83%). In the investigated period, the indirect costs represented 74,85% of the total cost. With time, the outcare overcame the hospital cost. In 2017 and 2018, outcare costs represented, respectively, 43,22% and 39,57% of total costs. During all the analyzed years, the costs and medical cares in CAPS were mostly for the feminine sex (77%). There was an increase of 107% in the number of patients with depression that received medical care in CAPS between 2013 and 2019. Those that received medical cares the most were of white color-race (38%) and brown (34 %), between the ages of 41 and 60 years old (49%). The diagnose of depressive episodes (65%) and the individual medical care (75%) were most frequent. The presumed CAPS' coverage was of 71% and 87% in the country, respectively, although with accentuated disparities between the states. Conclusion: Depression is a disease with elevated economical charge to the health system. Advancements were identified in the implementation of CAPS in the country, during 2013-2019. However, investments are still necessary, just as a bigger coverage of the services, because there are still inequalities bwtween the federative unities, in addition to reduced medical cares for groups and families, making the training of multi-professional and professional health teams that are able to pychosocial attention, necessary.

Effect of cognitive retraining treatment in mild to moderate depressive disorders

Background: Cognitive retraining or remediation approaches dispense high levels of stimulation and new learning tasks, leading to an increased neural connections, which facilitate rapid recovery in patients with neurological as well as psychiatric conditions. Objectives: The current study aimed to investigate the effect of cognitive retraining (CR) in depressive disorders. We assigned 40 patients with mild to moderate depression to two sample groups, with 20 participants each: CR alone and CR with medicine. A 6-week CR module was delivered, and participants' scores on measures such as the Beck Depression Inventory-II, Metacognition Questionnaire 30, World Health Organization Quality of Life- Brief, and Global Assessment of Functioning were compared. Results: Analysis using Stata/IC version 16 included descriptive statistics, paired and independent t-tests, analysis of covariance, and propensity score matching. Cohen's d was computed to determine the effect size. Within-group analysis revealed statistically significant differences in pre-post scores of the outcome measures (p < .05) and large effect size (d = 3.41; d = 3.60) in both groups. The difference in scores of outcome measures between the groups was not significant (p > .05) even when covariates were controlled, or nearest neighbor match analysis was carried out. CR is effective in alleviating symptoms and dysfunctional metacognitive beliefs in addition to enhancing functioning and quality of life. Conclusions: CR-based interventions may be essential mental health services owing to growing research in psychotherapy via virtual modes such as tele- and video-conferencing. These interventions can substantiate both prevention and remedy. (AU)

Epidemiological profile of suicide attempts in a municipality in southwest Paraná, from 2017 to 2020

SUMMARY OBJECTIVE: This study aimed to analyze the epidemiological profile and psychological disorder of the suicide attempt cases in Francisco Beltrão, Paraná. METHODS: This is an epidemiological descriptive/qualitative study of suicide attempts conducted between 2017 and 2020. This study used data from the Brazilian Information system for notifications involving suicide attempts (Sistema de Informação de Agravos de Notificação, SINAN) and 447 notifications were obtained. An analysis of the electronic medical record of these patients was performed in order to investigate the mental disorders, using a questionnaire. RESULTS: Of the 447 notifications, 382 were eligible for the study. Using the 95% confidence interval, there was a higher frequency of females with 71.7% aged between 18 and 35 years representing 48.4%, with 77.2% white race/color, the singles appeared in the majority with 47.6% with a history of previous suicide attempts, using exogenous intoxication as a method in the attempt with 67.5%. Regarding mental health, 66.5% of the patients had some mental disorders, with the highest prevalence of recurrent depressive disorder found in 40.6%. CONCLUSION: It was observed that there is a need for training of health professionals and implementation of programs and preventive measures aimed primarily at females aged between 18 and 35 years with mental disorders, especially with recurrent depressive disorder and with a history of previous suicide attempt.

Characteristics of the sleep-related beliefs in depressive patients comorbid with insomnia and its influence on sleep quality / 四川精神卫生

ObjectiveTo explore the beliefs and attitudes about sleep in patients with comorbid depressive disorder and insomnia， and to explore its influence on sleep quality. MethodsPatients with comorbid depressive disorder and insomnia （n=61） and patients with primary insomnia （n=62） who met criteria specified in the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） in Beijing Anding Hospital Affiliated to Capital Medical University were enrolled， meantime， another 64 healthy controls were recruited. All subjects were assessed using Dysfunctional Beliefs and Attitudes about Sleep （DBAS） and Pittsburgh Sleep Quality Index （PSQI）. Additionally， patients with comorbid depressive disorder and insomnia were evaluated using Hamilton Depression Scale-17 item （HAMD-17）. The PSQI and DBAS scores were compared among three groups using analysis of covariance， and multiple linear regression analysis was used to screen the factors affecting PSQI score in patients with comorbid depressive disorder and insomnia. ResultsCompared with healthy controls， higher scores of PSQI （t=18.932， 18.610， P<0.01） along with lower scores of DBAS （t=-5.561， -5.791， P<0.01） were observed in patients with comorbid depressive disorder and insomnia and patients with primary insomnia. Taking the PSQI score of patients with comorbid depressive disorder and insomnia as the dependent variable， statistically significant equations were generated using multiple linear regression analysis （F=14.095， R2=0.327， P<0.05）， and the predictive and control factors of sleep in DBAS and age were found to be the influencing factors of PSQI score in patients （B=-0.100， -0.279， P<0.05 or 0.01）. ConclusionCompared with the normal，depression patients with insomnia have more dysfunctional beliefs and attitudes towards sleep，and dysfunctional cognition may be the influencing factor of their sleep quality.

Factores asociados a la depresión en pacientes con enfermedad renal crónica avanzada en Boyacá, Colombia

Introducción: la enfermedad renal crónica avanzada se define como la presencia de daño renal y se caracteriza por alteraciones estructurales y funcionales que disminuyen la tasa de filtración glomerular. Esta enfermedad constituye un punto de cambio en la vida de las personas que la padecen, pues los obliga a diseñar estrategias mediante las cuales puedan reestructurar sus sueños, aspiraciones y proyectos de vida debido a que esta es una condición que cambia los estilos de vida y ocasiona otras entidades que afectan los niveles físico, psicológico y social. Objetivo: determinar los factores asociados a la depresión en personas con enfermedad renal crónica avanzada en población del departamento de Boyacá, Colombia. Materiales y métodos: se realizó un estudio transversal en 201 pacientes con enfermedad renal crónica en fases avanzadas y que estuvieran en manejo con terapia dialítica. Para la obtención de los datos se aplicó el cuestionario de depresión de Beck, además se incluyeron variables demográficas, sociales y clínicas. Resultados: la edad promedio de los participantes fue 58,5 años, el 76,11 % eran varones y la prevalencia de depresión fue de 40,29 %. Las personas con pareja estable y que cuentan con apoyo familiar y buena atención por parte del personal de salud tienen menos probabilidad de presentar depresión, mientras que los mayores de 50 años de edad, quienes llevan más dos años en terapia dialítica y aquellos que presentan otras enfermedades como diabetes mellitus y enfermedad pulmonar obstructiva crónica tienen probabilidades más altas de desarrollar depresión. Conclusiones: se considera prudente crear grupos de apoyo en las unidades de diálisis, donde se incluya a los pacientes y sus familiares, con el fin de detectar tempranamente problemas de salud mental y darles un manejo temprano, buscando de esta forma una adecuada adherencia al tratamiento de las patologías de base.

Introduction: Renal insufficiency is defined as the presence of renal damage and is characterized by structural and functional alterations with decreased glomerular filtration rate. This disease constitutes a turning point in the lives of people who suffer from it, since it requires elaborate forms or methods by which they can structure their dreams, aspirations and life projects additionally changing lifestyles, and generates other entities that affect the physical, psychological and social level. With this project they were determined the factors associated with depression in people with advanced chronic kidney disease in population of the department of Boyacá. Materials and methods: A cross-sectional study was conducted, which included patients with chronic kidney disease in advanced stages who were managed with dialysis therapy. Demographic, social and clinical variables were included. Where the Beck depression questionnaire was applied. Results: A total of 201 people participated. The average age was 58.5 years and 76.11 % were male. The prevalence of depression was 40.29 %. People with a stable partner, who have family support and good care from health personnel are less likely to have depression, while people over 50 years of age, with more than two years in dialysis therapy and the presence of Diseases such as diabetes mellitus and chronic obstructive pulmonary disease are more likely to develop depression. Conclusions: It is considered prudent to create support groups in dialysis units, where patients and their families are included, this in order to detect mental health problems early and give early management, thus seeking an adequate to the adherence of the underlying pathologies.

Psychological Problems Experienced by Patients with Bowel Endometriosis Awaiting Surgery / Problemas psicológicos vivenciados por pacientes com endometriose intestinal aguardando cirurgia

Abstract Objective To assess the most common psychological disturbances in women with deep endometriosis and bowel involvement who are waiting surgical treatment and to evaluate what forms of coping are used to solve the problem. Methods This was a cross-sectional observational study of 40 women diagnosed with deep endometriosis and intestinal symptoms. They completed two questionnaires: one for anxiety and depression (Hospital Anxiety and Depression Scale [ HADS]) and the Scale of Mode of Confronting Problems (EMEP, in the Portuguese acronym). Results We found that 77.1% of the patients had anxiety and depression, with anxiety being the most prevalent (87.5% of the patients); 90% of the patients used problem focused and religious introspection as their main modes of confronting problems. Conclusion In the use of the HADS questionary, two psychological aspects were the most present in women with deep endometriosis awaiting surgical treatment: anxiety and depression. The most used forms of coping to solve the problem were problem coping and religious practices.

Resumo Objetivo Avaliar os distúrbios psicológicos mais comuns em mulheres com endometriose profunda e acometimento intestinal que aguardam tratamento cirúrgico e avaliar as formas de enfrentamento que são usadas para resolver o problema. Métodos Estudo observacional transversal com 40 mulheres com diagnóstico de endometriose profunda e acometimento intestinal. As pacientes responderam dois questionários: para ansiedade e depressão (Hospital Anxiety and Depression Scale [HADS, na sigla em inglês) e outro para enfrentamento dos problemas (EMEP). Resultados Constatamos que 77% das pacientess apresentaram ansiedade e depressão, sendo a ansiedade a mais prevalente (87,5%); 90% das pacientes usaram a forma religiosa e focada no problema como sua principal estratégia de enfrentamento. Conclusão Os aspectos psicológicos mais encontrados em mulheres com endometriose profunda e intestinal que aguardam tratamento cirúrgico são ansiedade e depressão. As formas mais usadas de enfrentamento para resolver o problema foram práticas religiosas e focada no problema.

Cardiovascular risk factors and major depressive disorder: a cross-sectional study in São Paulo, Brazil

ABSTRACT BACKGROUND: Cardiovascular risk factors can mediate the association between depression and cardiovascular diseases. OBJECTIVE: To evaluate cardiovascular risk factors in adult individuals with and without histories of major depression in the metropolitan region of São Paulo, Brazil. DESIGN AND SETTING: Cross-sectional study in São Paulo (SP), Brazil. METHODS: This study evaluated 423 individuals without any lifetime diagnosis of major depression and 203 individuals with a previous diagnosis of major depression (n = 626). The participants underwent a psychiatric evaluation using a structured clinical interview (SCID-1), an anthropometric evaluation and a clinical evaluation that included blood pressure measurement and assessment of fasting blood glucose, lipid profile and physical activity levels. RESULTS: Individuals with histories of major depression were more likely to be female (P < 0.0001). Individuals with lifetime diagnoses of major depression were more likely to be current smokers (odds ratio, OR 1.61; 95% confidence interval, CI 1.01-2.59) and to have diabetes (OR 1.79; 95% CI 1.01-3.21); and less likely to be obese (OR 0.58; 95% CI 0.35-0.94). CONCLUSION: Individuals with major depression had higher odds of presenting tobacco smoking and diabetes, and lower odds of being obese. Healthcare professionals need to be aware of this, so as to increase the rates of diagnosis and treatment in this population.

Diet and depressive disorders

ABSTRACT Background: The importance of foods or food constituents in mental health is increasingly recognized, and "nutritional psychiatry" is a growing discipline. Objective: This narrative review aims to present work supporting associations between food or food constituents and mental health, specifically depressive disorders. Methods: The data presented is derived from preclinical and clinical work, including in vitro and in vivo assays, as well as observational studies and randomized clinical trials of dietary interventions. The focus of the review is the mediation of inflammatory processes and oxidative stress by dietary constituents that are an integral part of a healthy diet, such as the Mediterranean diet and similar. Results and Discussion: We present evidence for the role of the diet in prevention and management of depressive disorders, beyond the effect of individual nutrients. The findings indicate that among the dietary components with higher degree of evidence to influence depressive disorders are long chain n-3 polyunsaturated fatty acids (EPA and DHA), and various dietary bioactive compounds, especially plant-derived secondary metabolites represented by polyphenols such as flavonoids and resveratrol. Conclusion: Diet exerts an important role on mental health, and evidence indicates that some dietary constituents contribute to the prevention of depressive disorders.

Efectos de la rehabilitación cardiaca en el paciente cardiovascular con ansiedad y depresión / Effects of cardiac rehabilitation on the cardiovascular patient with anxiety

Resumen Objetivo: determinar el efecto de un programa de rehabilitación en los puntajes de ansiedad y depresión de pacientes con enfermedad cardiovascular. Materiales y métodos: se analizó la información de una cohorte retrospectiva de pacientes con enfermedad cardiovascular, admitidos a un programa de rehabilitación cardiaca. La ansiedad y depresión fueron medidas con la escala HADS (Hospital Anxiety and Depression Scale) y se categorizaron según el tratamiento de base recibido (médico o quirúrgico). Se comparó el cambio en los puntajes de ansiedad y depresión al ingreso y al final de la rehabilitación cardiaca mediante la prueba de Wilcoxon para muestras pareadas y la prueba de McNemar para evaluar el cambio de los porcentajes en cada subescala. Resultados: se incluyeron 1.221 pacientes. La mediana de edad fue 61 años, 68,30% eran hombres. Al ingreso, la mediana del puntaje de ansiedad y depresión fue 3, de los cuales 141 pacientes presentaron un trastorno de ansiedad (11,55%) y 67 un trastorno depresivo (5,49%). Al final de la rehabilitación cardiaca se obtuvo una mejoría en los puntajes de ansiedad y depresión tanto en pacientes en tratamiento médico (promedio -1,87 puntos 95% IC -2,14 a -1,60 p<0,01 y -1,46 puntos 95% IC -1,72 a -1,21 p<0,01 respectivamente) como quirúrgico (promedio -1,48 puntos 95% IC -1,78 a -1,18 p<0,01 y -1,83 puntos 95% IC -2,12 a -1,57 p<0,01). Conclusiones: los puntajes de ansiedad y depresión, en pacientes con enfermedad cardiovascular en tratamiento médico o quirúrgico, mejoraron luego de un programa integral de rehabilitación cardíaca.

Abstract Objective: To determine the effects of a rehabilitation program on the anxiety and depression scores of patients with cardiovascular disease. Materials and methods: An analysis was performed on the information collected from a retrospective cohort of patients with cardiovascular disease, admitted to a cardiac rehabilitation program. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS), and were classified according to the baseline treatment (medical or surgical) received. A comparison was made between the anxiety and depression scores on admission and at the end of the cardiac rehabilitation program using Wilcoxon test for paired samples and the McNemar test to evaluate the change in the percentages in each sub-scale. Results: A total of 1,221 patients were included. The median age was 61 years, and 68.3% were males. On admission, the median score was 3 on the anxiety and depression scale, with 141 (11.55%) patients having an anxiety disorder, and 67 (5.49%) with depressive disorder. An improvement was observed in the anxiety and depression scores at the end of the end of the cardiac rehabilitation, both in patients on medical treatment (mean difference minus 1.87 points, 95% CI; -2.14 to -1.60: P<.01, and -1.46 points, 95% CI; -1.72 to -1.21: P<.01, for anxiety and depression, respectively) and on surgical treatment (mean difference -1.48 points, 95% CI; -1.78 to -1.18, P<.01 and -1.83 points, 95% CI -2.12 to -1.57, P<.01, respectively). Conclusions: The anxiety and depression scores in patients with cardiovascular disease on medical or surgical treatment improved after an integrated cardiac rehabilitation program.

Effects of Srog dzin-5 prescription on pathogenesis model of acute stress and animal models of depressive disorders / Монголын эм зүй, эм судлал

Abstract@#There is a growing need for a systematic study of the use of medicines prepared from herbal, animal, and mineral raw materials in traditional Mongolian medicine to a new level. Based on traditional medicine technology and use, the study identified the most suitable modern medicinal ingredients for the human body, namely a medicine that can be used for depression in the ancient scripture, “Ngo mtshar dga’ ston gter mdzod” by Gelen Choijamts and further practical application is imperative. @*Purpose@#To study the effects of Srog dzin-5 prescription on pathogenesis model of acute stress and animal models of depressive disor- ders. @*Conclusion@#</br>1. In the pathogenesis model of acute stress disorder caused by restricted mobility, Srog dzin-5 prescription prevents stress-induced thymic involution and enlargement of adrenal glands. </br>2. In the pathogenesis model of ethanol-induced depression, Srog dzin-5 prescription increased physical activity, reduced despair, and prevented anxiety according to behavioral assessment.

Índice de depresión y de inhabilidad social del Rorschach en adultos con trastornos depresivos / Rorschach index of depression and social disability in adults with depressive disorders

RESUMEN El Psicodiagnóstico de Rorschach es una prueba proyectiva que se aplica en la evaluación de la personalidad y trastornos psicopatológicos. Constituyó una investigación aplicada, descriptiva-transversal con un enfoque cuantitativo, entre 2015 y 2018. El presente texto tiene como objetivo analizar la frecuencia de las variables del Índice de depresión y del Índice de inhabilidad social en protocolos de adultos con trastornos depresivos residentes en la provincia de Camagüey. Los 210 protocolos pertenecientes a sujetos con trastornos depresivos que conformaron la muestra, fueron seleccionados de manera intencional pura, no probabilística. En la generalidad de los protocolos, el Índice de depresión no fue eficaz para diagnosticar la depresión de los sujetos y el Índice de inhabilidad social fue positivo. Las variables más frecuentes en el Índice de depresión y de inhabilidad social indican la presencia de una actividad cognitiva poco elaborada, escasa sensibilidad hacia el propio mundo personal y hacia el entorno, así como dificultades en la esfera de relaciones interpersonales. El estudio responde a la Cátedra Honorífica Hermann Rorschach de la Universidad de Camagüey.

ABSTRACT The Rorschach Psychodiagnosis is a projective test that is applied in the evaluation of personality and psychopathological disorders. It was an applied, descriptive-cross-sectional research with a quantitative approach, between 2015 and 2018. This text aims to analyze the frequency of the variables of the Depression Index and the Social Disability Index in protocols for adults with depressive disorders residing in the Camagüey province. The 210 protocols belonging to subjects with depressive disorders that made up the sample were intentionally selected in a pure, non-probabilistic manner. In most protocols, the Depression Index was not effective in diagnosing subjects' depression, and the Social Disability Index was positive. The most frequent variables in the Depression and Social Disability Index indicate the presence of poorly developed cognitive activity, low sensitivity to one's personal world and the environment, as well as difficulties in the sphere of interpersonal relationships. The study responds to the Hermann Rorschach Honorary Chair at the University of Camagüey.

Depression among nursing students and its association with academic life / Depresión entre estudiantes de enfermería y su asociación con la vida estudiantil / Depressão entre estudantes de enfermagem e sua associação com a vida acadêmica

ABSTRACT Objective: To measure the levels of depression among Nursing students from a public institution of higher education and the association with aspects of academic life. Method: Analytical and quantitative study with 203 students from a higher education institution that uses active methodologies. We used Beck's Depression Inventory and the Likert type scale of academic factors. Results: We verified that 19.2% had moderate or severe levels of depression. Higher levels of depression were associated with female gender (p=0.003), working more than 40 hours per week (p=0.047), spending more than 90 minutes to reach academic activities (p=0.043) and with 12 academic factors specific to routines of the studied institution. Conclusion: The results contribute to managers' and professors' reflection and analysis concerning nursing students' mental health, in addition to indicating in which aspects there is a need to provide greater support to these students.

RESUMEN Objetivo: Medir los niveles de depresión entre estudiantes de enfermería de una institución pública de enseñanza superior y la asociación con aspectos de la vida estudiantil. Método: Estudio analítico y cuantitativo con 203 estudiantes de una institución de enseñanza superior que utiliza metodologías activas. Se utilizó el Inventario de Depresión de Beck y la escala de factores académicos del tipo Likert. Resultados: se verificó que el 19,2% presentó niveles de depresión moderados o graves. Los mayores niveles de depresión se asociaron al sexo femenino (p = 0,003), trabajar más de 40 horas semanales (p = 0,047), gastar más de 90 minutos para llegar a las actividades académicas (p = 0,043) y a 12 factores estudiantiles específicos a las rutinas de la institución estudiada. Conclusión: los resultados contribuyen con gestores y docentes en la reflexión y el análisis de la salud mental de los estudiantes de enfermería, además de indicar en qué aspectos hay necesidad de proporcionar mayor apoyo a esos estudiantes.

RESUMO Objetivo: Medir os níveis de depressão entre estudantes de Enfermagem de uma instituição pública de ensino superior e a associação com aspectos da vida acadêmica. Método: Estudo analítico e quantitativo com 203 estudantes de uma instituição de ensino superior que utiliza metodologias ativas. Utilizaram-se o Inventário de Depressão de Beck e a escala de fatores acadêmicos do tipo Likert. Resultados: Verificou-se que 19,2% apresentaram níveis de depressão moderados ou graves. Maiores níveis de depressão foram associados ao sexo feminino (p=0,003), trabalhar mais de 40 horas semanais (p=0,047), despender mais de 90 minutos para chegar às atividades acadêmicas (p=0,043) e a 12 fatores acadêmicos específicos às rotinas da instituição estudada. Conclusão: Os resultados contribuem com gestores e docentes na reflexão e na análise da saúde mental dos discentes de enfermagem, além de indicar em quais aspectos há necessidade de fornecer maior apoio a esses estudantes.

Athlete Girls Mental Health Status on the Basis of Experimental Psychological Research Method

Nowadays, the topic of confrontation of personality is negative environmental factors are highly relevant. Violent social, economic changes in society postpone the imprint on the mental health of a person, especially girls, which directly affects the physical condition, causing stress, neurosis, depressive states, apathy, inadequate behaviour. Methods: This article gives concept of athlete girls’ involved in handball (n=184) psycho-emotional state and its influence on health and activities. Describes review of methods assessing the psycho-emotional state of a person. Analysed methods, used in the laboratory of Tashkent Institute Postgraduate Medical Education. The article focuses on the use of scale personal anxiety Spilberger-Khanin and Lusher. Results: light anxiety-depressive disorders in 45.0%, moderate violations were detected in 40% and severe in 15%. When testing for age characteristics, 70% of girls were over 17 years old. 30% of cases accounted for age gradation up to 17 years, which is the most prosperous age. the most severe type of personality disorders occurred among girls engaged in trainings during one year, because the girls prepared for the competition, they were more neurotic. The most acceptable period of time according to our research is 2 years. Disorders of moderate severity is detected in athletes during sports for 3 years. Conclusions: A change in the psycho-emotional state is indeed in close relationship with the physical state of a person. Experimental psychological testing of girls after increased loads revealed mild anxiety and depressive disorders in 45%, moderate 40% and severe 15%.

Mental health resources and awareness of anxiety and depressive disorders in general hospitals in China

Abstract Background Mental health disorders are common in China. There is a lack of knowledge and resources of mental health in China. Objectives To assess the levels of psychiatric resources and services in general hospitals in China. Methods Data regarding psychiatric departments, wards and staff were collected from 57 general hospitals in four provinces of China (Hubei, Zhejiang, Heilongjiang and Yunnan) between April 2014 and June 2014. Questionnaires were distributed to 1,200 non-psychiatric clinicians. Results Among the 57 hospitals, 50 provided mental health services, 36 had mental health wards, and seven had neither mental health clinics nor wards. The median number of mental health clinicians was six per hospital. The median number of specialized nurses was 42 per hospital. A total of 1,152 non-psychiatric clinicians with a career duration of 9.4 ± 8.9 years returned completed questionnaires. Only 6.9% reported a good understanding of the manifestation of anxiety and depressive disorders, 4.5% reported a good understanding of the diagnostic criteria, and 3.8% reported a good understanding of the treatment protocols. Discussion There is inadequate awareness of anxiety and depressive disorders among non-psychiatric clinicians in general hospitals in China. This awareness/understanding increased with increasing hospital level.

Prevalence Rate Of Depression Among Elderly Population In Central India

The adult population is booming at an alarming rate leading to the most difficult challenges faced by both developing and developed nations. The rapid changes in social and cultural values have marked influence on the psychological well being of the elderly. Depression among the elderly remains unrecognized or inadequately treated condition. The goal of this study was to determine the magnitude of depression in elderly people living in central India. MATERIALS AND METHOD- 200 elderly individuals of 60 years of age or more reporting to the institute who gave consent for the study were screened. While those individuals who refused to provide consent were excluded. Demographic details were recorded, and level of depression was assessed using Geriatric depression scale (Sheikh & Yesavage, 1986.) RESULT: The data was analysed and the results were recorded. The Chi-square test was used for categorical variables. In this study, severe depression was found in 30% elderly while 50% were mildly depressed. Also, Women were more depressed as compared to men. CONCLUSION- The high prevalence of depression among elderly especially females emphasize increased need of family and community support and availability of better health care services. The small sample size of this study is limitation, so large-scale studies are needed for a better picture of mental health in rural older adults in India.

Depressive Disorders among People with Chronic Illness in an Urban Area of South India

Over the past decades, twin demographic and epidemiological transitions have been reflected an increase in the burden of chronic diseases. Although public health practitioners have recognized the increasing burden, the socioeconomic and overall health impact is to be adequately researched. Depressive disorders are considered an important correlate, for appropriate management of chronic disease but have been given relatively less importance. Hence, this study was taken up in an urban slum of Bengaluru city to explore the associations between depressive disorders and chronic diseases.Methodology: The cross-sectional community-based study was conducted in an urban slum of Bengaluru city using a modified cluster sampling technique. All persons who were ill or on long-term medication or were hospitalized for a period more than 3 weeks in the past 1 year were interviewed. A semi-structured pre-tested questionnaire incorporating Hamilton Depression Rating Scale was used. Results: He overall prevalence of chronic illness was 10% among the study population with 10.9% having mild depression, and 1.2% having mild-moderate depression, and none severe depression. None of them were taking any treatment for their depression. The mean age of those with mild depression was 53.9 years and was greater among females (males 5.0% and females 16.7%). The latter was highly statistically significant. Of the 91 persons with symptoms of mild depression, nearly two-thirds (58.2%) belonged to Class IV of Modified B G. Prasad’s classification. Factor analysis showed that HAM-D scores to have a significant relation with chronic illness. Discussion: Depressive disorders among those with chronic disorders are hitherto unrecognized in routine clinical practice. Middle ages, females and those lower down in the socioeconomic hierarchy are at greater risk. There is a need to establish a mechanism for appropriate management of these disorders.