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1.
Medicine (Baltimore) ; 99(22): e20185, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481383

RESUMO

The risk of colorectal cancer associated to antidepressant use remains unclear. The purpose of this meta-analysis was to investigate the risk of colorectal cancer associated to antidepressant use.Medline, Embase, Web of Science, and Cochrane Database were accessed from the dates of their establishment to October 2018, to collect study of antidepressant use and colorectal cancer morbidity and mortality. Then a meta-analysis was conducted using Stata 12.0 software.A total of 11 publications involving 109,506 participants were included. The meta-analysis showed that antidepressant use was not associated with colorectal cancer morbidity (relevant risk (RR): 0.97; 95% confidence interval (CI): 0.94-1.01) and mortality (RR: 1.08; 95% CI: 0.99-1.17). Subgroup analysis showed selective serotonin reuptake inhibitor (RR: 0.99; 95% CI: 0.96-1.03) or serotonin norepinephrine reuptake inhibitor (RR: 1.04; 95% CI: 0.86-1.26) were not associated with colorectal cancer risk; however, TCA was associated with colorectal cancer risk decrement (RR: 0.92; 95% CI: 0.87-0.98). Furthermore, the results also showed that antidepressant use was not associated with colorectal cancer risk in Europe and North America (RR: 0.97; 95% CI: 0.92-1.02) and Asia (RR: 1.00; 95% CI: 0.95-1.26). Additionally, a dose-response showed per 1 year of duration of antidepressant use incremental increase was not associated with colorectal cancer risk (RR: 0.96; 95% CI: 0.87-1.09).Evidence suggests that antidepressant use was not associated with colorectal cancer morbidity and mortality. The cumulative duration of antidepressant use did not utilized played critical roles.


Assuntos
Antidepressivos/administração & dosagem , Antidepressivos/efeitos adversos , Neoplasias Colorretais/epidemiologia , Transtorno Depressivo/tratamento farmacológico , Antidepressivos Tricíclicos/administração & dosagem , Antidepressivos Tricíclicos/efeitos adversos , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/psicologia , Relação Dose-Resposta a Droga , Humanos , Fatores de Risco , Inibidores da Recaptação de Serotonina e Norepinefrina/administração & dosagem , Inibidores da Recaptação de Serotonina e Norepinefrina/efeitos adversos
2.
Rev Bras Epidemiol ; 23: e200059, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32578675

RESUMO

OBJECTIVE: Antidepressant use is increasing worldwide, but national data on psychotropic drug use by depressed patients in Brazil is lacking. METHODOLOGY: Between 2013 and 2014, a representative sample of urban adult individuals were asked if they had a diagnosis of chronic disease, had a medical indication for drug treatment, and were taking chronic medications at the time for each reported diagnosis. We analyzed the frequencies of reported depression and the medications related to this disease. RESULTS: Overall, 6.1% of respondents reported depression. The prevalence increased with age - 9.5% among the elders - was higher among women (8.9%) and in the south of the country (8.9%). As a single disease, the prevalence of depression was higher among young people (17.6%). Among those with multimorbidity, the prevalence of depression rose to 25.7%. Of those who reported depression, 81.3% had medical indication for treatment and 90.3% were under treatment - this proportion was lower among young people (84.5%) and those living in the poorest region (78.6%). Antidepressants accounted for 47.2% of psychotropic drugs taken by respondents with depression, with regional differences - only 30% used antidepressants in the North. Polypharmacy was reported by 22% of those with depression and other chronic diseases. CONCLUSION: Depression in Brazil, is common among young adults as a single chronic disease and highly prevalent among people with chronic multimorbidity, especially the young. The treatment gap was larger among young people and in the less developed regions of the country.


Assuntos
Antidepressivos/uso terapêutico , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/epidemiologia , Psicotrópicos/uso terapêutico , Autorrelato , População Urbana/estatística & dados numéricos , Adulto , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polimedicação , Distribuição por Sexo , Fatores Socioeconômicos , Adulto Jovem
3.
Rev Lat Am Enfermagem ; 28: e3274, 2020.
Artigo em Português, Espanhol, Inglês | MEDLINE | ID: mdl-32491123

RESUMO

OBJECTIVE: to analyze the occurrence of leave of absence due to depression among workers. METHOD: census, descriptive-analytical study, with retrospective collection. Population composed of 2,267 workers on leave due to depression with data from the Unified Benefits Information System. The independent variables were: sex, age group, income; county, origin, number of leaves of absence and type of benefit. For data analysis, descriptive statistics were used and the chi-square and Fisher's exact tests were applied. The variables that presented a value of p≤0.20 were submitted to logistic regression. RESULTS: there was a predominance of females, age ≥50 years, from the capital, with income of one to two minimum wages, urban origin and single removal. Single leaves of absence occurred mainly due to a mild depressive episode and the benefit granted to the significant majority was social security sickness benefit. Among those who were on leave of absence more than once, the main cause was recurrent depressive disorder, a current mild episode and, in terms of benefit, social security sickness benefit. There was a statistical association between total time and absence from work. In logistic regression, it was found that the time ≥60 days, was 3.1 times longer in recurrent depressive disorder. CONCLUSION: there were an expressive quantitative number of absences due to depression, in which it was observed, especially, that the absence time remained long.


Assuntos
Transtorno Depressivo/epidemiologia , Licença Médica/estatística & dados numéricos , Adulto , Brasil/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador/estatística & dados numéricos , Estudos Retrospectivos , Fatores Socioeconômicos , Adulto Jovem
4.
Rev Assoc Med Bras (1992) ; 66(3): 307-313, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32520150

RESUMO

OBJECTIVE: To identify or use alcohol abuse and abuse in the IAMSPE elderly, through the application of AUDIT, socioeconomic characterization of the elderly, and problems associated with drinking and weight, if there is a relationship between depression and alcohol abuse. METHODS: This is a cross-sectional, exploratory, and descriptive study with a quantitative approach. One hundred elderly patients were interviewed to apply a socioeconomic form and to assess alcohol consumption from AUDIT. RESULTS: correlation between alcohol consumption and female gender (p = 0.021). Most of the participants were between 60 and 79 years old, were female, had a partner, had completed elementary school, had income and selected house, were retired and unemployed. CONCLUSION: In the present study, we found no correlation between alcohol abuse and depression; Only one correlation was found between male gender and higher alcohol abuse. However, a significant prevalence of moderate use of high alcohol was found (3.9% in women and 21.7% in men), i.e., it poses a risk to the health of the elderly.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Alcoolismo/epidemiologia , Fatores Etários , Idoso , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Alcoolismo/diagnóstico , Estudos Transversais , Transtorno Depressivo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários
5.
Rev Saude Publica ; 54: 49, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32491095

RESUMO

OBJECTIVE To evaluate the existing literature on the association between parents' depression and anxiety and their influence on their children's weight during childhood, identifying possible mechanisms involved in this association. METHODS A systematic search of the literature was conducted in the PubMed, PsycINFO and SciELO databases, using the following descriptors: (maternal OR mother* OR parent* OR paternal OR father) AND ("common mental disorder" OR "mental health" OR "mental disorder" OR "depressive disorder" OR depress* OR anxiety OR "anxiety disorder") AND (child* OR pediatric OR offspring) AND (overweight OR obes* OR "body mass index" OR BMI). A total of 1,187 articles were found after peer selection. RESULTS In total, 16 articles that met the inclusion criteria were selected for the review. Most of them investigated depressive symptoms and only three, symptoms of maternal anxiety. The evaluated studies suggested a positive association between symptoms of maternal depression and higher risk of childhood obesity. The results diverged according to the chronicity of depressive symptoms (episodic or recurrent depression) and income of the investigated country (high or middle income). Mechanisms were identified passing by quality of parenthood, affecting behaviors related to physical activity and child-feeding, as mediators of the association. CONCLUSIONS We conclude there is evidence of a positive relationship between the occurrence of maternal symptoms of depression and anxiety and childhood obesity. It is emphasized the need for a better understanding on the effect of depressive symptoms and the contextual factors involved in this relationship so that effective intervention strategies can be implemented.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Pais/psicologia , Obesidade Pediátrica/psicologia , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Relações Pais-Filho , Fatores Socioeconômicos
6.
JAMA ; 323(21): 2188-2189, 2020 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-32484531
7.
Fa Yi Xue Za Zhi ; 36(2): 223-228, 2020 Apr.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32530171

RESUMO

Abstract: Objective To investigate the factors affecting changes of Symptom Check List-90 (SCL-90) of patients with traumatic subdural effusion. Methods One hundred and forty-two cases of patients with traumatic subdural effusion from the Center of Forensic Identification, Wannan Medical College collected from 2007-2018 were tested with SCL-90. The differences between SCL-90 results and the national norm and the influences of gender, age, education level, the number of effusion sites and location on SCL-90 results were analyzed. Results The differences between the scores of somatization, interpersonal sensitivity, depression, anxiety, hostility, terror, paranoia and psychosis factors and total mean scores in SCL-90 of traumatic subdural effusion and that of the national norm had statistical significance (P<0.05). The differences in depression and hostility factor scores between males and females had statistical significance (P<0.05). The differences in compulsion, anxiety and terror factor scores and total mean scores among different age groups had statistical significance (P<0.05). The differences in hostility, paranoia and psychosis factors among patients with different degrees of education had statistical significance (P<0.05). The differences in depression, anxiety, hostility and terror factor scores and total mean scores among single-site group, double-site group and multi-site group had statistical significance (P<0.05). The differences in somatization, depression and anxiety factor scores and total mean scores between the right cerebral hemisphere group and the left cerebral hemisphere group and bilateral hemisphere group had statistical significance (P<0.05). Conclusion Traumatic subdural effusion can cause certain psychological changes, which are related to the primary trauma of arachnoid tear as well as the number and location of effusion sites. Attention should be paid to the influence of the above factors during the assessment of psychological symptoms.


Assuntos
Derrame Subdural , Ansiedade , Depressão , Transtorno Depressivo , Feminino , Humanos , Masculino , Inquéritos e Questionários
8.
Indian J Ophthalmol ; 68(6): 994-998, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32461412

RESUMO

Purpose: To evaluate the psychological impact of the COVID 19 crisis on ophthalmologists-in-training and practising ophthalmologists during lockdown in India. Methods: An online survey was completed by ophthalmologists and ophthalmology trainees during the lockdown. The information collected included demographics (age, gender), domicile (state, union territory), current professional status (in training or practising), type of practice (solo, group, institutional, governmental, non-governmental), marital status (married, single), impact of COVID-19 on their training or practice, and impact on income and ability to meet living expenses. Psychological distress was assessed using the Patient Health Questionnaire-9 (PHQ-9). Results: In all, 2,355 ophthalmologists responded. Mean age was 42.5 (range, 25-82 years; SD, 12.05) years. Of these, 1,332 (56.7%) were males; 475 (20.2%) were still not in practice; 366 (15.5%) were single; 1,244 (52.8%) felt that COVID-19 would impact on their training or professional work; and 869 (37%) had difficulty in meeting their living expenses. The mean PHQ-9 score was 3.98 (range, 0-27; SD, 4.65). In terms of psychological impact, 768 (32.6%) had some degree of depression; mild in 504 (21.4%), moderate in 163 (6.9%), and severe in 101 (4.3%). Multivariable analysis showed that depression was significantly higher at younger age. The odds of depression decreased by 3% with 1 year increase in age. It was higher in non-practicing ophthalmologists, especially those who were considerably worried about their training or professional growth, and those with difficulty in meeting living expenses. Conclusion: A strikingly high proportion of ophthalmologists are psychologically affected and may require personalized mental health care.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Internato e Residência , Oftalmologistas/psicologia , Oftalmologia/educação , Pneumonia Viral/psicologia , Estresse Psicológico/epidemiologia , Estudantes de Medicina/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/epidemiologia , Transtorno Depressivo/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Fatores de Risco
10.
Lancet Psychiatry ; 7(6): 506-514, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32445689

RESUMO

BACKGROUND: Cognitive bias modification (CBM) therapies, including attention bias modification, interpretation bias modification, or approach and avoidance training, are prototypical examples of mechanistically derived treatments, but their effectiveness is contentious. We aimed to assess the relative effectiveness of various CBM interventions for anxious and depressive symptomatology. METHODS: For this systematic review and network meta-analysis, we searched PubMed, PsycINFO, Embase, and Cochrane Central Register from database inception up until Feb 7, 2020. We included randomised controlled trials of CBM versus control conditions or other forms of CBM for adults aged 18 years and older with clinical or subclinical anxiety or depression measured with a diagnostic interview or a validated clinical scale. We excluded studies comparing CBM with a non-CBM active intervention. Two researchers independently selected studies and evaluated risk of bias with the Cochrane Collaboration tool. Primary outcomes encompassed anxiety and depressive symptoms measured with validated clinical scales. We computed standardised mean differences (SMDs) with a restricted maximum likelihood random effects model. This study is registered with PROSPERO, CRD42018086113. FINDINGS: From 2125 records we selected 85 trials, 65 (n=3897) on anxiety and 20 (n=1116) on depression. In a well connected network of anxiety trials, interpretation bias modification outperformed waitlist (SMD -0·55, 95% CI -0·91 to -0·19) and sham training (SMD -0·30, -0·50 to -0·10) for the primary outcome. Attention bias modification showed benefits only in post-hoc sensitivity analyses excluding post-traumatic stress disorder trials. Prediction intervals for all findings were large, including an SMD of 0. Networks of depression trials displayed evidence of inconsistency. Only four randomised controlled trials had low risk of bias on all six domains assessed. INTERPRETATION: CBM interventions showed consistent but small benefits; however heterogeneity and risk of bias undermine the reliability of these findings. Larger, definitive trials for interpretation bias modification for anxiety might be warranted, but insufficient evidence precludes conclusions for depression. FUNDING: Romanian Ministry of Research and Innovation, The National Council for Scientific Research-The Executive Agency for Higher Education, Research, Development and Innovation Funding.


Assuntos
Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Transtorno Depressivo/terapia , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto , Transtornos de Ansiedade/psicologia , Viés , Estudos de Casos e Controles , Terapia Cognitivo-Comportamental/tendências , Transtorno Depressivo/psicologia , Humanos , Metanálise em Rede , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Transtornos de Estresse Pós-Traumáticos/psicologia
11.
Lancet Psychiatry ; 7(6): 491-505, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32445688

RESUMO

BACKGROUND: Dissociative seizures are paroxysmal events resembling epilepsy or syncope with characteristic features that allow them to be distinguished from other medical conditions. We aimed to compare the effectiveness of cognitive behavioural therapy (CBT) plus standardised medical care with standardised medical care alone for the reduction of dissociative seizure frequency. METHODS: In this pragmatic, parallel-arm, multicentre randomised controlled trial, we initially recruited participants at 27 neurology or epilepsy services in England, Scotland, and Wales. Adults (≥18 years) who had dissociative seizures in the previous 8 weeks and no epileptic seizures in the previous 12 months were subsequently randomly assigned (1:1) from 17 liaison or neuropsychiatry services following psychiatric assessment, to receive standardised medical care or CBT plus standardised medical care, using a web-based system. Randomisation was stratified by neuropsychiatry or liaison psychiatry recruitment site. The trial manager, chief investigator, all treating clinicians, and patients were aware of treatment allocation, but outcome data collectors and trial statisticians were unaware of treatment allocation. Patients were followed up 6 months and 12 months after randomisation. The primary outcome was monthly dissociative seizure frequency (ie, frequency in the previous 4 weeks) assessed at 12 months. Secondary outcomes assessed at 12 months were: seizure severity (intensity) and bothersomeness; longest period of seizure freedom in the previous 6 months; complete seizure freedom in the previous 3 months; a greater than 50% reduction in seizure frequency relative to baseline; changes in dissociative seizures (rated by others); health-related quality of life; psychosocial functioning; psychiatric symptoms, psychological distress, and somatic symptom burden; and clinical impression of improvement and satisfaction. p values and statistical significance for outcomes were reported without correction for multiple comparisons as per our protocol. Primary and secondary outcomes were assessed in the intention-to-treat population with multiple imputation for missing observations. This trial is registered with the International Standard Randomised Controlled Trial registry, ISRCTN05681227, and ClinicalTrials.gov, NCT02325544. FINDINGS: Between Jan 16, 2015, and May 31, 2017, we randomly assigned 368 patients to receive CBT plus standardised medical care (n=186) or standardised medical care alone (n=182); of whom 313 had primary outcome data at 12 months (156 [84%] of 186 patients in the CBT plus standardised medical care group and 157 [86%] of 182 patients in the standardised medical care group). At 12 months, no significant difference in monthly dissociative seizure frequency was identified between the groups (median 4 seizures [IQR 0-20] in the CBT plus standardised medical care group vs 7 seizures [1-35] in the standardised medical care group; estimated incidence rate ratio [IRR] 0·78 [95% CI 0·56-1·09]; p=0·144). Dissociative seizures were rated as less bothersome in the CBT plus standardised medical care group than the standardised medical care group (estimated mean difference -0·53 [95% CI -0·97 to -0·08]; p=0·020). The CBT plus standardised medical care group had a longer period of dissociative seizure freedom in the previous 6 months (estimated IRR 1·64 [95% CI 1·22 to 2·20]; p=0·001), reported better health-related quality of life on the EuroQoL-5 Dimensions-5 Level Health Today visual analogue scale (estimated mean difference 6·16 [95% CI 1·48 to 10·84]; p=0·010), less impairment in psychosocial functioning on the Work and Social Adjustment Scale (estimated mean difference -4·12 [95% CI -6·35 to -1·89]; p<0·001), less overall psychological distress than the standardised medical care group on the Clinical Outcomes in Routine Evaluation-10 scale (estimated mean difference -1·65 [95% CI -2·96 to -0·35]; p=0·013), and fewer somatic symptoms on the modified Patient Health Questionnaire-15 scale (estimated mean difference -1·67 [95% CI -2·90 to -0·44]; p=0·008). Clinical improvement at 12 months was greater in the CBT plus standardised medical care group than the standardised medical care alone group as reported by patients (estimated mean difference 0·66 [95% CI 0·26 to 1·04]; p=0·001) and by clinicians (estimated mean difference 0·47 [95% CI 0·21 to 0·73]; p<0·001), and the CBT plus standardised medical care group had greater satisfaction with treatment than did the standardised medical care group (estimated mean difference 0·90 [95% CI 0·48 to 1·31]; p<0·001). No significant differences in patient-reported seizure severity (estimated mean difference -0·11 [95% CI -0·50 to 0·29]; p=0·593) or seizure freedom in the last 3 months of the study (estimated odds ratio [OR] 1·77 [95% CI 0·93 to 3·37]; p=0·083) were identified between the groups. Furthermore, no significant differences were identified in the proportion of patients who had a more than 50% reduction in dissociative seizure frequency compared with baseline (OR 1·27 [95% CI 0·80 to 2·02]; p=0·313). Additionally, the 12-item Short Form survey-version 2 scores (estimated mean difference for the Physical Component Summary score 1·78 [95% CI -0·37 to 3·92]; p=0·105; estimated mean difference for the Mental Component Summary score 2·22 [95% CI -0·30 to 4·75]; p=0·084), the Generalised Anxiety Disorder-7 scale score (estimated mean difference -1·09 [95% CI -2·27 to 0·09]; p=0·069), and the Patient Health Questionnaire-9 scale depression score (estimated mean difference -1·10 [95% CI -2·41 to 0·21]; p=0·099) did not differ significantly between groups. Changes in dissociative seizures (rated by others) could not be assessed due to insufficient data. During the 12-month period, the number of adverse events was similar between the groups: 57 (31%) of 186 participants in the CBT plus standardised medical care group reported 97 adverse events and 53 (29%) of 182 participants in the standardised medical care group reported 79 adverse events. INTERPRETATION: CBT plus standardised medical care had no statistically significant advantage compared with standardised medical care alone for the reduction of monthly seizures. However, improvements were observed in a number of clinically relevant secondary outcomes following CBT plus standardised medical care when compared with standardised medical care alone. Thus, adults with dissociative seizures might benefit from the addition of dissociative seizure-specific CBT to specialist care from neurologists and psychiatrists. Future work is needed to identify patients who would benefit most from a dissociative seizure-specific CBT approach. FUNDING: National Institute for Health Research, Health Technology Assessment programme.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Transtornos Dissociativos/terapia , Convulsões/terapia , Adulto , Transtorno Depressivo/psicologia , Transtornos Dissociativos/epidemiologia , Transtornos Dissociativos/psicologia , Inglaterra/epidemiologia , Feminino , Humanos , Análise de Intenção de Tratamento/métodos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente/estatística & dados numéricos , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Escócia/epidemiologia , Convulsões/psicologia , Índice de Gravidade de Doença , Resultado do Tratamento , País de Gales/epidemiologia
12.
Brain Behav Immun ; 87: 172-176, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32405150

RESUMO

The pandemic caused by Covid-19 has been an unprecedented social and health emergency worldwide. This is the first study in the scientific literature reporting the psychological impact of the Covid-19 outbreak in a sample of the Spanish population. A cross-sectional study was conducted through an online survey of 3480 people. The presence of depression, anxiety and post-traumatic stress disorder (PTSD) was evaluated with screening tests from 14 March. Sociodemographic and Covid-19-related data was collected. Additionally, spiritual well-being, loneliness, social support, discrimination and sense of belonging were assessed. Descriptive analyses were carried out and linear regression models compiled. The 18.7% of the sample revealed depressive, 21.6% anxiety and 15.8% PTSD symptoms. Being in the older age group, having economic stability and the belief that adequate information had been provided about the pandemic were negatively related to depression, anxiety and PTSD. However, female gender, previous diagnoses of mental health problems or neurological disorders, having symptoms associated with the virus, or those with a close relative infected were associated with greater symptomatology in all three variables. Predictive models revealed that the greatest protector for symptomatology was spiritual well-being, while loneliness was the strongest predictor of depression, anxiety and PTSD. The impact on our mental health caused by the pandemic and the measures adopted during the first weeks to deal with it are evident. In addition, it is possible to identify the need of greater psychological support in general and in certain particularly vulnerable groups.


Assuntos
Infecções por Coronavirus/psicologia , Saúde Mental/tendências , Pneumonia Viral/psicologia , Estresse Psicológico/epidemiologia , Adulto , Idoso , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Betacoronavirus/patogenicidade , Estudos Transversais , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Espanha/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Inquéritos e Questionários
16.
18.
Am J Med ; 133(4): e160, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32331573
19.
Am J Med ; 133(4): e161, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32331574
20.
East Asian Arch Psychiatry ; 30(1): 20-27, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32229643

RESUMO

BACKGROUND: The binarian model views melancholia as a distinct depressive class, whereas the unitarian model views it as a more severe expression of depression. This study aims to investigate the sociodemographic, clinical, and course differences between melancholic and non-melancholic depression. METHODS: This prospective observational study was carried out at Kasturba Hospital, Manipal, India from November 2010 to September 2011. We recruited consecutive inpatients aged 18 to 60 years who have a diagnosis of depressive disorder (based on ICD-10), with or without any psychiatric or physical comorbidities. Patients were categorised into melancholia and non-melancholia using the CORE questionnaire, with scores of ≥8 indicating the presence of melancholic depression. In addition, patients were evaluated using the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Somatoform Symptom Checklist, Columbia Suicide Severity Rating Scale, Clinical Global Impression, and Presumptive Stressful Life Events Scale at baseline and at 1, 3, and 6 months. RESULTS: Of 87 inpatients with a diagnosis of depression, 50 met the inclusion criteria and 37 were excluded. Compared with patients with non-melancholic depression, patients with melancholic depression had higher depression score (30.8 vs 23.8, p < 0.001), had higher number of patients with psychotic depression (39.1% vs 7.4%, p = 0.007), had higher overall illness severity score (5.9 vs 4.8, p < 0.001), and had higher number of patients with suicidal ideation and suicidal behaviour. Regarding the course of melancholia, the number of melancholic patients decreased from 23 at baseline to eight at 1 month, three at 3 months, and three at 6 months. Scores of non-interactiveness, retardation, and agitation decrease significantly over 3 months. CONCLUSIONS: The construct and course of melancholia may be viewed as a part of depression, more in line with severe depression. Melancholia increases the risk for suicidal ideation and suicidal behaviour.


Assuntos
Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Adolescente , Adulto , Feminino , Humanos , Índia/epidemiologia , Pacientes Internados/psicologia , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
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