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1.
Pharmacol Res ; 164: 105376, 2021 02.
Article in English | MEDLINE | ID: mdl-33316383

ABSTRACT

Depression is a common global mental disorder that seriously harms human physical and mental health. With the development of society, the increase of pressure and the role of various other factors make the incidence of depression increase year by year. However, there is a lack of drugs that have a fast onset, significant effects, and few side effects. Some volatile oils from traditional natural herbal medicines are usually used to relieve depression and calm emotions, such as Lavender essential oil and Acorus tatarinowii essential oil. It was reported that these volatile oils, are easy to enter the brain through the blood-brain barrier and have good antidepressant effects with little toxicity and side effects. In this review, we summarized the classification of depression, and listed the history of using volatile oils to fight depression in some countries. Importantly, we summarized the anti-depressant natural volatile oils and their monomers from herbal medicine, discussed the anti-depressive mechanisms of the volatile oils from natural medicine. The volatile oils of natural medicine and antidepressant drugs were compared and analyzed, and the application of volatile oils was explained from the clinical use and administration routes. This review would be helpful for the development of potential anti-depressant medicine and provide new alternative treatments for depressive disorders.


Subject(s)
Antidepressive Agents/administration & dosage , Depression/drug therapy , Depressive Disorder/drug therapy , Oils, Volatile/administration & dosage , Plant Oils/administration & dosage , Animals , Antidepressive Agents/chemistry , Antidepressive Agents/classification , Depression/classification , Depressive Disorder/classification , Humans , Oils, Volatile/chemistry , Oils, Volatile/classification , Phytotherapy , Plant Oils/chemistry , Plant Oils/classification , Plants, Medicinal
2.
Behav Brain Res ; 395: 112845, 2020 10 01.
Article in English | MEDLINE | ID: mdl-32758506

ABSTRACT

Until now, depression research has taken a surprisingly narrow approach to modelling the disease, mainly focusing on some form of psychomotor retardation within a mechanistic framework of depression etiology. However, depression has many symptoms and each is associated with a vast number of substrates. Thus, to deepen our insights, this SI ("Depression Symptoms") reviewed the behavioral and neurobiological sequelae of individual symptoms, specifically, psychomotor retardation, sadness, low motivation, fatigue, sleep/circadian disruption, weight/appetite changes, and cognitive affective biases. This manuscript aims to integrate the most central information provided by the individual reviews. As a result, a dynamic model of depression development is proposed, which views depression as a cumulative process, where different symptoms develop at different stages, referred to as early, intermediate, and advanced, that require treatment with different pharmaceutical agents, that is, selective serotonin reuptake inhibitors early on and dopamine-based antidepressants at the advanced stage. Furthermore, the model views hypothalamic disruption as the source of early symptoms and site of early intervention. Longitudinal animal models that are capable of modelling the different stages of depression, including transitions between the stages, may be helpful to uncover novel biomarkers and treatment approaches.


Subject(s)
Depression/classification , Depression/physiopathology , Depressive Disorder, Major/etiology , Animals , Antidepressive Agents/therapeutic use , Brain/physiopathology , Circadian Rhythm/physiology , Depressive Disorder, Major/classification , Depressive Disorder, Major/drug therapy , Disease Models, Animal , Dopamine/therapeutic use , Fatigue/psychology , Humans , Hypothalamus/physiopathology , Motivation , Sadness/psychology , Selective Serotonin Reuptake Inhibitors/therapeutic use
3.
Fam Syst Health ; 38(2): 172-183, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32525351

ABSTRACT

INTRODUCTION: Primary care is a common access point for children and adolescents with depression and suicidality concerns. In this setting, pediatricians typically function as front-line providers given barriers that patients face in accessing mental health clinicians. METHOD: This study surveyed chief residents from all pediatric residency programs in the United States (N = 214) to evaluate (a) their attitudes, knowledge, practices, and comfort in managing depression and suicidality concerns in primary care, and (b) the relationship between residency training processes and pediatric residents' practices, knowledge, and comfort related to identifying and managing depression and suicidality. RESULTS: The usable response rate was 37.6%. The large majority of respondents are involved in evaluation and management of depression and suicidality; yet many respondents reported a lack of knowledge and comfort in these roles. CONCLUSIONS: Recommendations for pediatric residency program training processes are discussed, including the potential added value of colocating mental health clinicians into the primary care continuity training clinic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Subject(s)
Depression/classification , Physicians/psychology , Suicide/classification , Adult , Delivery of Health Care, Integrated , Depression/psychology , Education, Medical, Graduate/methods , Female , Humans , Internship and Residency/methods , Male , Mass Screening/methods , Pediatrics/methods , Physicians/statistics & numerical data , Primary Health Care/methods , Primary Health Care/statistics & numerical data , Qualitative Research , Suicide/psychology , Surveys and Questionnaires , United States
4.
Games Health J ; 9(4): 255-264, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32053021

ABSTRACT

Background: Despite the variety of available treatments for mental health symptoms, many individuals do not engage with treatment and among those who do, dropout rates are often high. Therefore, providing alternative opportunities to access treatment is imperative. Research interest in the therapeutic effects of digital mental health initiatives and serious games has grown in recent years, but the potential of simple, easy-to-use casual videogames (CVGs) that can be played in short bursts of time has seldom been considered. Objective: The objective of the present study is to provide a systematic review of the literature examining the effects of CVGs on treating anxiety, depression, stress, and low mood. Method: A systematic search was conducted, using the terms (casual gam* or casual videogam* or mini gam* or minigam* or mini-gam* or gamif*) and (mental health or anx* or depress* or stress or mood) and (study or trial or treatment or prescribed or prevention) as "Title," "Abstracts," "Keywords," or "Topic" words across all years. A Google search was also completed to check for articles that may have been missed. Results: N = 13 studies met inclusion criteria (no studies were added via the Google search). These studies reported findings for nine different CVGs, with six studies aimed at reducing anxiety, two examining effects for depression, and four investigating the effects of CVGs on treating stress or low mood. Promising effects were identified. Conclusion: CVGs may have promise for treating anxiety, depression, stress, and low mood.


Subject(s)
Play Therapy/standards , Video Games/standards , Adult , Anxiety/classification , Anxiety/psychology , Anxiety/therapy , Depression/classification , Depression/psychology , Depression/therapy , Humans , Mood Disorders/classification , Mood Disorders/psychology , Mood Disorders/therapy , Play Therapy/instrumentation , Play Therapy/trends , Stress, Psychological/classification , Stress, Psychological/psychology , Stress, Psychological/therapy , Video Games/psychology , Video Games/trends
5.
Br Dent J ; 211(12): E24, 2011 Dec 16.
Article in English | MEDLINE | ID: mdl-22193507

ABSTRACT

OBJECTIVE: The aim of this audit was to investigate complex chronic facial pain patients' satisfaction after an initial, comprehensive, 45-60 minute consultation visit. DESIGN: Prospective audit using a post-visit satisfaction survey. SETTING: Specialised outpatient facial pain unit. METHODS: A convenience sample of 50 consecutive new patients were recruited. History, pain and psychosocial functioning were assessed through standard, validated pre-visit questionnaires. A post-visit satisfaction questionnaire was sent (twice if necessary) to patients by mail, and non-responders were contacted by telephone. MAIN OUTCOME MEASURES: Patients' satisfaction scores on pain management processes were evaluated. RESULTS: Response rate for the questionnaire was 63% (32/50) and 12 additional patients who did not respond to the questionnaire replied by telephone. Among questionnaire respondents, mean overall patient satisfaction was 8.1 ± 2.2 on an 11-point scale (best score 10), with no differences based on age, gender, diagnosis, length of symptoms and treatment. There was a trend of higher overall satisfaction among patients referred by dentists and specialists. Patients who had seen at least one specialist before their visit reported higher scores in understanding the reasons for their condition and what to do to treat their condition. CONCLUSIONS: A consultation with adequate time for history taking, addressing patients' goals and thorough explanation accompanied by written information, results in high satisfaction among patients with chronic facial pain.


Subject(s)
Chronic Pain/therapy , Dental Audit , Facial Pain/therapy , Hospital Units , Pain Clinics , Patient Satisfaction , Adult , Ambulatory Care , Anxiety/classification , Chronic Pain/diagnosis , Chronic Pain/psychology , Comprehensive Dental Care , Counseling , Dentist-Patient Relations , Depression/classification , Facial Pain/diagnosis , Facial Pain/psychology , Female , Humans , Male , Medical History Taking , Middle Aged , Pain Measurement , Patient Care Planning , Patient Education as Topic , Prospective Studies , Referral and Consultation , Surveys and Questionnaires
6.
Alzheimers Dement ; 6(1): 63-9, 2010 Jan.
Article in English | MEDLINE | ID: mdl-20129320

ABSTRACT

OBJECTIVES: We compared the prevalence of subtypes of depression in patients with Alzheimer's disease (AD), vascular dementia (VaD), and unspecified dementia (UD). METHODS: Using the Integrated Healthcare Information Services database, we conducted an analysis of subtypes of depression (major depressive disorder, depressive disorder not otherwise specified, dysthymic disorder; depressive psychosis, and adjustment disorder depressive) among patients with AD, VaD, and UD. Six thousand four hundred and forty patients aged 60 years or older with dementia (2947 with AD, 725 with VaD, and 2768 with UD) were identified from January 1 to December 31, 2001. Both subtypes of depression and dementia subgroups were diagnosed using criteria from the International Classification of Diseases, 9th version. RESULTS: The overall prevalence of depressive disorders was 27.41%. The prevalence of depressive disorders was significantly higher in VaD (44.14%) and UD (32.48%) patients compared with AD (18.53%, P < .0001) patients. The AD patients had the lowest prevalence of all subtypes of depression. The VaD patients, compared with both AD and UD (P < .005), had a significantly higher prevalence of: 1) depressive disorder not otherwise specified, 2) major depressive disorder, and 3) dysthymic disorder. Adjustment disorder with depressive symptoms was more common in the UD subgroup, whereas the rate of depressive psychosis was similar in all dementia subgroups CONCLUSIONS: This study supports the view that depressive disorders are more prevalent in VaD compared with UD and AD, and provides indicators to the clinician for further evaluation of depression in dementia subgroups.


Subject(s)
Alzheimer Disease/epidemiology , Dementia/epidemiology , Depression/classification , Depression/epidemiology , Age Factors , Aged , Aged, 80 and over , Chi-Square Distribution , Dementia/classification , Female , Humans , International Classification of Diseases , Male , Middle Aged , Neuropsychological Tests , Prevalence , Psychiatric Status Rating Scales , Risk Factors , Sex Factors
8.
Gac. méd. Caracas ; 116(1): 10-17, mar. 2008. tab
Article in Spanish | LILACS | ID: lil-630518

ABSTRACT

La depresión, y la ansidad acompañante, es la manifestación psicológica más frecuente e intensa del sufrimiento humano, que en casos extremos termina en el suicidio. A pesar que puede restringir significativamente la calidad de vida del individuo, su interacción personal o social y productividad, sorprende que a nivel de la atención médica primaria no sea reconocida en la mitad de los casos y sea tratada en sólo la mitad de los diagnósticos. Sin embargo, es responsabilidad del médico internista estar preparado para reconocer la depresión y tratarla eficientemente, por las siguientes razones: 1. La medicina interna propone como concepción fundamental la visión integral del paciente; 2. El funcionamiento de la mente normal y patológica se fundamenta en principios biológicos; 3. La ansiedad y la depresión son las manifestaciones emocionales más frecuentes en la práctica médica, presentándose como desórdenes primarios o como condiciones asociadas a otros desórdenes psiquiátricos y enfermedades médicas (incluyendo a sus tratamientos), o que resultan del impacto emocional de las enfermedades médicas y quírurgicas. La referencia al psiquiatra debe hacerse en: depresión severa, respuesta terapéutica insatisfactoria, evidencia de psicosis o ideación suicida. En la depresión la herramienta básica es una relación médico-paciente solida, que garantice la integridad y la libertad del paciente y preserve el secreto profesional, que adquiere especial relevancia al abordar los sentimientos, las emociones y la conducta humana. Aunque útiles, las pruebas y escalas de la depresion no sustituyen a la entrevista personal con el paciente, que permite apreciar el ánimo depresivo y la anhedonia, resultantes de la desolación y el estado de indefensión que abruma al paciente. En la manía, extrema opuesto del espectro del animo, la agitación, el lenguaje expansivo y grandilocuente y la irritabilidad, pueden acompañar a la irracionalidad psicótica. La anormalidades de los neurotransmisores


Depression, and adjoined anxiety, is the most frequent and intense psychological manifestation of human suffering, which in extreme cases could lead to suicide. Even though it could affect significantly the quality of life, interpersonal and social interactions and individual productivity, it astonishes that at primary care, only half of the cases are diagnosed, and only half of those diagnosed are actually treated. However, it is the responibility of the Internist to recognize depression and treat it efficiently for the following reasons: 1. Internal medicine proposes the integral view of the patient as its fundamental conception; 2. Functioning of mind, both normal and pathological, is established in biological principles; 3. In medical practice, anxiety and depression are the most frequent emotional manifestations, either as primary disorders or as associated conditions to others psychiatric and medical diseases (including their treatments), or by the emotional impact of medical and surgical disorders. Psychitric referral should be made in severe depression, unsatisfactory therapeutic response and evidence of psychosis or suicidal ideation. In managing depression, a solid medical-patient relatioship is fundamental to guarantee patient liberty and integrity and to preserve professional secret, which acquires special relevance when dealing with human senses, emotions and behavior. Test and scales for depression, although useful, do not substitute the personal interview with patients that allow us to appreciate depressive mood and anhedonia, which result from the desolation and defenseless state that oppress the patient. In mania, opposite extreme of mood spectrum, the agitation, expansive and grandiloquent language as well as the irritability could be accompanied by psychotic irrationality. Abnormalities in norepinephrine and serotonin neutotransmitters play an important role in mood disorders, their levels and effects are less actives in depression


Subject(s)
Humans , Male , Female , Anxiety/etiology , Depression/classification , Depression/pathology , Depression/psychology , Suicide/psychology , Mental Disorders/psychology , Internal Medicine , Public Health , Mental Disorders/therapy
9.
Inform Prim Care ; 15(3): 143-50, 2007.
Article in English | MEDLINE | ID: mdl-18005561

ABSTRACT

BACKGROUND: Routinely collected general practice computer data are used for quality improvement; poor data quality including inconsistent coding can reduce their usefulness. OBJECTIVE: To document the diversity of data entry systems currently in use in UK general practice and highlight possible implications for data quality. METHOD: General practice volunteers provided screen shots of the clinical coding screen they would use to code a diagnosis or problem title in the clinical consultation. The six clinical conditions examined were: depression, cystitis, type 2 diabetes mellitus, sore throat, tired all the time, and myocardial infarction. We looked at the picking lists generated for these problem titles in EMIS, IPS, GPASS and iSOFT general practice clinical computer systems, using the Triset browser as a gold standard for comparison. RESULTS: A mean of 19.3 codes is offered in the picking list after entering a diagnosis or problem title. EMIS produced the longest picking lists and GPASS the shortest, with a mean number of choices of 35.2 and 12.7, respectively. Approximately three-quarters (73.5%) of codes are diagnoses, one-eighth (12.5%) symptom codes, and the remainder come from a range of Read chapters. There was no readily detectable consistent order in which codes were displayed. Velocity coding, whereby commonly-used codes are placed higher in the picking list, results in variation between practices even where they have the same brand of computer system. CONCLUSIONS: Current systems for clinical coding promote diversity rather than consistency of clinical coding. As the UK moves towards an integrated health IT system consistency of coding will become more important. A standardised, limited list of codes for primary care might help address this need.


Subject(s)
Data Display/standards , Informatics/standards , Private Practice/classification , Private Practice/standards , Depression/classification , Depression/epidemiology , Humans , Software , United Kingdom
10.
Homeopatia Méx ; 76(647): 11-18, mar.-abr. 2007.
Article in Spanish | LILACS | ID: lil-514393

ABSTRACT

La depresión es un estado psíquico de abatimiento, y a veces de postración, que suele acompañarse, en el aspectosomático, de astenia, es decir, de una flaqueza y debilidad más o menos acentuada. Por lo tanto la depresión esun estado psíquico en que están disminuidas las energías morales y físicas del individuo.


Subject(s)
Humans , Depression/classification , Depression/epidemiology , Depression/history , Depression/therapy , Homeopathy
11.
Homeopatia Méx ; 76(647): 11-18, mar.-abr. 2007.
Article in Spanish | HomeoIndex Homeopathy | ID: hom-8648

ABSTRACT

La depresión es un estado psíquico de abatimiento, y a veces de postración, que suele acompañarse, en el aspectosomático, de astenia, es decir, de una flaqueza y debilidad más o menos acentuada. Por lo tanto la depresión esun estado psíquico en que están disminuidas las energías morales y físicas del individuo.


Subject(s)
Humans , Depression/classification , Depression/epidemiology , Depression/history , Depression/therapy , Homeopathy
12.
Aust Fam Physician ; 36(1-2): 93-4, 2007.
Article in English | MEDLINE | ID: mdl-17310543

ABSTRACT

The Registrar Research Workshop has been a feature of Australian general practice training since 1994. Twenty five general practice registrars attend the annual 3 day event, which aims to develop registrars' understanding of the research process. Presenters and facilitators are drawn from the academic general practitioner and primary health care research community. Presentations alternate with small group sessions, where groups of five registrars are guided through the process of developing a research question, identifying appropriate research methods, and addressing ethical and funding concerns, before preparing a presentation about their research proposal for their peers. Research questions are developed from unanswered questions that have arisen in registrars' clinical practice.


Subject(s)
Biomedical Research , Education , Neck Pain , Sexual Behavior , Vaccinium macrocarpon , Acupuncture , Adolescent , Contraception, Postcoital , Depression/classification , Dermoscopy , Female , Humans , Male , Neck Pain/therapy , Physicians, Family/education , Urinary Tract Infections/therapy
13.
J Psychiatr Ment Health Nurs ; 14(1): 21-32, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17244002

ABSTRACT

This paper explores descriptors of depression and begins by exploring nursing descriptors including the nature of assessment and nursing diagnosis and progresses to underpin these major processes by considering social descriptors such as cultural and spiritual constructs. The role and influence of stigma is discussed and an examination of gender influences and experiences is undertaken. The paper concludes by examining personal descriptors in the literature. The overall aim of the paper is (1) to add to nursing knowledge by depicting the grounded realities of the experience of depression and (2) stimulate discussion on the need to provide holistic care pathways that are responsive to the uniqueness of this lived experience and finally to (3) encourage further research on key psycho-social factors associated with depression and the concurring advancement of nursing care. This paper has been completed in the context of an ongoing study into the grounded experience of 'Depression' and the development of a psychiatric nursing theory of connectivity.


Subject(s)
Attitude of Health Personnel , Culture , Depression/classification , Depression/psychology , Language , Nurses , Female , Humans , Male , Psychology
14.
J Integr Neurosci ; 5(1): 89-110, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16544368

ABSTRACT

INTRODUCTION: Depression is characterized by disturbances in affect, cognition, brain and body function, yet studies have tended to focus on single domains of dysfunction. An integrated approach may provide a more complete profile of the range of deficits characterized by depressed individuals, but it is unclear whether this approach is able to predict depression severity over and above that predicted by single tasks or domains of function. In this study, we examined the value of combining multiple domains of function in predicting depression severity. METHODS: Participants contained in the International Brain Database, (http://www.brainresource.com) had completed three testing components including a web-based questionnaire of Personal History, the Brain Resource Cognition battery of Neuropsychological tests, Personality assessment and Psychophysiological testing. Two hundred and sixty six of these participants were able to be classified as either non-depressed, mild-moderately or severely (non-clinically) depressed, based on a depression screening questionnaire. Analysis of variance identified variables on which the categorized participants differed. Significant variables were then entered into a series of stepwise regressions to examine their ability to predict depression scores. RESULTS: An integrated model including measures of affect (increased Neuroticism; decreased Emotional Intelligence), cognition (increased variability of reaction time during a working memory task; decreased "name the word component score" in the verbal interference task), brain (decreased left-lateralized P150 ERP component during a working memory task) and body function (increased negative skin conductance level gradient) were found to predict more of the variation in depression severity than any single domain of function. DISCUSSION: On the basis of behavioral as well as Psychophysiological findings reported in this study, it was suggested that deficits in subclinically depressed individuals are more pronounced during automatic stages of stimulus processing, and that performance in these individuals may improve (to the level displayed by controls) when task demands are increased. Findings also suggest that it is important to consider disturbances across different domains of function in order to elucidate depression severity. Each domain may contribute unique explanatory information consistent with an integrative model of depression, taking into account the role of both behavior and underlying neural changes.


Subject(s)
Depression/diagnosis , Depression/physiopathology , Neuropsychological Tests/statistics & numerical data , Psychiatric Status Rating Scales/statistics & numerical data , Acoustic Stimulation/methods , Affect/physiology , Analysis of Variance , Case-Control Studies , Cognition/physiology , Depression/classification , Electroencephalography/methods , Evoked Potentials/physiology , Female , Humans , Male , Memory, Short-Term/physiology , Models, Statistical , Personality Assessment/statistics & numerical data , Predictive Value of Tests , Psychophysics , Regression Analysis , Surveys and Questionnaires
15.
Eur J Epidemiol ; 20(4): 359-63, 2005.
Article in English | MEDLINE | ID: mdl-15971509

ABSTRACT

Tea drinking has been suggested to be beneficial in neurodegenerative diseases where depressive mood is a common symptom. Nevertheless, it is not known whether there are any associations between tea drinking and depression in general populations. In this study we investigated these associations in a sample of the Finnish general population (n = 2011) using a postal questionnaire and the Beck Depression Inventory (BDI). Those who reported drinking tea daily were less depressed than the others. They had a lower mean BDI score and also a lower prevalence of depression. None of those whose daily tea intake was five cups or more had depression. Several potential confounding factors were included in the final sex- and age-adjusted multivariate logistic regression model which suggested that those who drink tea daily may have a significantly reduced risk of being depressed (adjusted odds ratio 0.47, 95% confidence interval 0.27-0.83). In conclusion, an inverse relationship between daily tea drinking and the risk of being depressed was found in a relatively large general population sample. Nevertheless, the underlying mechanisms are unresolved and further studies are needed.


Subject(s)
Depression/epidemiology , Tea , Adult , Caffeine , Depression/classification , Female , Finland/epidemiology , Humans , Male , Middle Aged , Multivariate Analysis , Surveys and Questionnaires
16.
Eur Arch Psychiatry Clin Neurosci ; 255(1): 40-7, 2005 Feb.
Article in English | MEDLINE | ID: mdl-15538592

ABSTRACT

Efficacy and tolerability of Hypericum LI 160 was compared to fluoxetine and placebo in mild to moderate Major Depression (DSM-IV) in a 4-week randomized, double-blind trial. One hundred and sixty-three outpatients from 15 general practitioner centers received either 900 mg Hypericum LI 160, 20 mg fluoxetine, or placebo daily. Amelioration was measured by the Hamilton and the Montgomery-Asberg Depression scales. Response and remission rates and global ratings by investigators and patients were measured. Adverse event reports, laboratory screening, vital signs, physical exams and ECG were collected. No significant differences could be observed regarding efficacy measures except for remission rate (Hypericum 24%; fluoxetine 28%; placebo 7 %). Hypericum was significantly better tolerated than fluoxetine. Hypericum LI 160 or fluoxetine were not more effective in short-term treatment in mild to moderate depression than placebo.


Subject(s)
Antidepressive Agents, Second-Generation/therapeutic use , Depression/drug therapy , Fluoxetine/therapeutic use , Outpatients , Plant Extracts/therapeutic use , Adult , Analysis of Variance , Chi-Square Distribution , Depression/classification , Depression/physiopathology , Double-Blind Method , Drug Evaluation , Electroencephalography/methods , Female , Follow-Up Studies , Humans , Hypericum , Male , Middle Aged , Prospective Studies , Psychiatric Status Rating Scales , Statistics, Nonparametric , Time Factors , Treatment Outcome
17.
Psychopharmacology (Berl) ; 164(3): 301-8, 2002 Nov.
Article in English | MEDLINE | ID: mdl-12424554

ABSTRACT

RATIONALE: Although extracts from Hypericum have long played a major role in the treatment of mild to moderate depression, information pertaining to the drug's therapeutic profile is sparse. OBJECTIVES: To investigate whether the administration of the Hypericum extract has a selective effect on particular signs and symptoms of depression as opposed to a more general acceleration of recovery. METHODS: A meta-analysis was performed on the original data of three double-blind, randomized multicenter trials, during which 544 out-patients suffering from mild to moderate depression according to DSM-IV criteria received 3x300 mg/day Hypericum extract (WS 5570 or WS 5572) or placebo over a double-blind treatment period of 6 weeks. The primary outcome measure for treatment efficacy in the original trials was the change in the total score of the Hamilton Rating Scale for Depression (HAMD, 17-item version) between baseline and treatment end. The relationship between the symptoms of depression represented by the items of the HAMD was assessed by means of cluster analysis and individual item analysis. RESULTS: Two clusters of items were identified which were stable in several independent subsets of the full data set. While cluster 1 (HAMD items 1, 2, 3, 7, 8, 12, 13, 14, 16) was interpreted to represent the core symptoms of depression (including somatic aspects), cluster 2 (items 4, 5, 6, 9, 10, 11, 15, 17) was primarily composed of items assessing depression-related anxiety and insomnia. In both clusters, Hypericum extract reduced the symptoms of depression more effectively than placebo. However, the herbal drug was particularly effective in the core symptoms of the disorder. CONCLUSIONS: The results indicate that Hypericum extract accelerated the recovery from depression in a rather general manner, by influencing all investigated signs and symptoms of the disease. The drug's therapeutic profile was thus found to be similar to the profile of selective serotonin reuptake inhibitors.


Subject(s)
Antidepressive Agents/therapeutic use , Cluster Analysis , Depression/drug therapy , Hypericum/chemistry , Depression/classification , Female , Humans , Male , Plant Extracts/therapeutic use , Randomized Controlled Trials as Topic
18.
Br Dent J ; 191(9): 513-5, 2001 Nov 10.
Article in English | MEDLINE | ID: mdl-11726064

ABSTRACT

OBJECTIVE: To investigate salivary cortisol levels in patients undergoing third molar removal under local and general anaesthesia. DESIGN: Random sampling of two independent groups. METHODS: Samples of saliva were collected from patients prior to and after surgery for the removal of impacted wisdom teeth. The samples were analysed to assess cortisol levels. Patients were also asked to complete a Hospital Anxiety and Depression questionnaire on the day of surgery. RESULTS: Patients receiving treatment under local anaesthesia showed lower levels of stress response than those having treatment under general anaesthesia on the actual day of surgery did (Fig. 1). No other significant differences were noted. CONCLUSION: Local anaesthesia is the preferred mode of pain control for patients who express no strong preference for type of anaesthetic.


Subject(s)
Hydrocortisone/analysis , Molar, Third/surgery , Saliva/chemistry , Self-Assessment , Stress, Physiological/classification , Stress, Psychological/classification , Tooth Extraction , Tooth, Impacted/surgery , Adult , Anesthesia, Dental , Anesthesia, General , Anesthesia, Local , Anxiety/classification , Attitude to Health , Depression/classification , Follow-Up Studies , Humans , Statistics as Topic , Stress, Physiological/metabolism , Stress, Psychological/metabolism
19.
J Am Osteopath Assoc ; 101(9): 517-23, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11575038

ABSTRACT

The authors assessed the impact of osteopathic manipulative treatment (OMT) as an adjunct to standard psychiatric treatment of women with depression. Premenopausal women with newly diagnosed depression were randomly assigned to either control (osteopathic structural examination only; n = 9) or treatment group (OMT; n = 8). Both groups received conventional therapy consisting of the antidepressant paroxetine (Paxil) hydrochloride plus weekly psychotherapy for 8 weeks. Attending psychiatrists and psychologists were blinded to group assignments. No significant differences existed between groups for age or severity of disease. After 8 weeks, 100% of the OMT treatment group and 33% of the control group tested normal by psychometric evaluation. No significant differences or trends were observed between groups in levels of cytokine production (IL-1, IL-10, IL-2, IL-4, and IL-6) or in levels of anti-HSV-1, anti-HSV-2, and anti-EBV antibody. There was no pattern to the osteopathic manipulative structural dysfunctions recorded. The findings of this pilot study indicate that OMT may be a useful adjunctive treatment for alleviating depression in women.


Subject(s)
Depression/rehabilitation , Manipulation, Orthopedic/methods , Osteopathic Medicine/methods , Adult , Antidepressive Agents, Second-Generation/therapeutic use , Depression/classification , Depression/drug therapy , Depression/immunology , Double-Blind Method , Female , Humans , Middle Aged , Paroxetine/therapeutic use , Physical Examination/methods , Pilot Projects , Prospective Studies , Psychometrics , Psychotherapy , Treatment Outcome
20.
Schmerz ; 15(2): 116-25, 2001 Apr.
Article in German | MEDLINE | ID: mdl-11810342

ABSTRACT

PROBLEM: This paper presents a new approach to music therapeutic treatments. We developed a short time treatment ( 8 group sessions) for patients suffering from chronic headaches. The multimodal concept of this headache treatment and particularly the effect of a sound trance on headache patients are explained and evaluated in this paper. METHODS: An evaluation study was done with 34 patients, who belonged to four therapy groups. In order to evaluate this treatment the patients were interviewed and had to fill out several self-rating scales about pain and some psychological variables (e. g. depression) before, directly after and 6-12 months after the treatment. This treatment group (n=26) was compared to a small waiting group (n=9). A case study elucidated the psycho-social anamnesis, and the process and outcome of the music therapy. RESULTS: The case study shows that the sound trance caused a loss of the affect control or at least reduced it. This experience enabled the patients to develop creative solutions, which resulted in a pain relief 6-12 month later. The comparison of the statistic means directly before and after the treatment did not reveal many therapeutic effects. Yet, 6-12 months later many patients reported less days at which they suffered from headaches; and they also significantly improved their ability of pain control. CONCLUSION: The results indicate that music therapy groups are more successful than a waiting group. The study's results agree with numerous other psychological evaluation studies and shows once more that music therapists working with patients suffering from chronic headaches are able to achieve successful results particularly long-dated. Thus, creative therapeutic approaches supplement the medical treatment, as they help the patients to develop an adaptive way of coping their pain. Yet, it will need further research to confirm the benefit of music therapy for patients suffering from chronic pain.


Subject(s)
Headache/therapy , Music Therapy , Adult , Chronic Disease , Depression/classification , Female , Headache/psychology , Humans , Interviews as Topic , Male , Middle Aged , Pain Measurement , Reference Values
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