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1.
Orv Hetil ; 161(10): 374-381, 2020 Mar.
Artículo en Húngaro | MEDLINE | ID: mdl-32115991

RESUMEN

Introduction: Pregnancy is usually desired, yet it has its own difficulties that can be overwhelming, thus depression might occur. The prevalence of this is 6.58-26.7% in the international literature and 6.5-17.9% in Hungarian studies. Aim: The aim was to analyze the data of the perinatal depression screening program of Békéscsaba which started in 2014. We wanted to study the pathological rate and the connection between demographic data and depression symptoms. Method: Until august 2019, 1708 women took part in the program. The screening is done by perinatal nurses: they explain the aims and hand over the Edinburgh Postnatal Depression Scale three times during pregnancy and once postpartum. They also suggest women in need to attend the psychological intervention as part of the screening. Results: The prevalence of the pathological questionnaires were 15.31%, 14.29%, 11.87%, and 12.68% at the four measuring occasions. In the whole sample, 18.27% of women had pathological score at least once. The depression scores of the four measurements correlated significantly with each other. Women who did not plan their pregnancies had higher level of depression in all four measurements. In the first trimester, women who were under 21 years old and/or were single had higher depression scores. In the second trimester, multipara women tended to have higher scores. Conclusion: The high prevalence and the constant level of depression emphasize the importance of the screening and psychological intervention, as previous studies found connection between depression and some perinatal complications. Some demographic factors can indicate more vulnerable women. Orv Hetil. 2020; 161(10): 374-381.


Asunto(s)
Depresión Posparto/psicología , Depresión/diagnóstico , Tamizaje Masivo/métodos , Complicaciones del Embarazo/psicología , Atención Prenatal/métodos , Adulto , Depresión/epidemiología , Depresión/psicología , Depresión Posparto/diagnóstico , Depresión Posparto/epidemiología , Femenino , Humanos , Hungría/epidemiología , Edad Materna , Atención Perinatal , Embarazo , Atención Prenatal/estadística & datos numéricos , Prevalencia , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Adulto Joven
2.
Adv Exp Med Biol ; 1191: 219-235, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32002932

RESUMEN

Although anxiety and depression have been considered as two distinct entities according to the diagnostic criteria, anxious depression (comorbid anxiety and depression) is relatively a common syndrome. According to the DSM-5 criteria, it uses "with anxious distress specifier" to define anxious depression in its MDD section. Anxious depression is known to have different neurobiological profiles compared to non-anxious depression. Several studies have revealed significant differences between anxious depression and non-anxious depression regarding the hypothalamic-pituitary-adrenal (HPA) axis function, structural and functional brain imaging findings, inflammation markers, etc. Patients with anxious depression were significantly more likely to be found in primary care setting and more likely to be associated with female gender, non-single, unemployed, less educated, and more severe depression. Previous reports also showed that patients with anxious depression had more frequent episodes of major depression and a higher risk of suicidal ideation and previous suicide attempts than those with non-anxious depression. Although anxious depression is known to be associated with poor treatment outcomes in several studies, recent researches have sought to find better treatment strategy to improve patients with anxious depression.


Asunto(s)
Trastornos de Ansiedad/complicaciones , Trastornos de Ansiedad/terapia , Trastorno Depresivo Mayor/complicaciones , Trastorno Depresivo Mayor/terapia , Ansiedad/complicaciones , Ansiedad/diagnóstico , Ansiedad/terapia , Trastornos de Ansiedad/diagnóstico , Comorbilidad , Depresión/complicaciones , Depresión/diagnóstico , Depresión/terapia , Trastorno Depresivo Mayor/diagnóstico , Humanos
3.
Medicine (Baltimore) ; 99(1): e18461, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31895777

RESUMEN

This study was conducted to examine the effect of protective factors on the relationship between crisis episodes and depression in the elderly population in Taiwan.In this study, the Taiwan Longitudinal Study on Aging was used as basis for a cross-sectional secondary data analysis. After eliminating respondents below the age of 65 years and those with missing values, 2426 samples were collected. Predictive variables, such as crisis episodes, personal resources, family ties, social participation, and social support, were investigated, and the dependent variable of "depression status" was measured using the Center for Epidemiologic Studies Depression scale.According to the results of regression analysis, the protective factors of self-assessed health (ß = -0.290, P < .001), instrumental support (ß = -0.153, P < .001), financial satisfaction (ß = -0.126, P < .001), emotional support (ß = -0.101, P < .001), crisis episodes (ß = 0.087, P < .001), support satisfaction (ß = -0.081, P < .001), leisure participation (ß = -0.053, P < .05), family ties (ß = -0.048, P < .05), and community participation (ß = -0.042, P < .05) had a significant effect on depression status. Moreover, leisure participation had a moderating effect on the relationship between crisis episodes and depression (ß = -0.07, P < .01). In addition, according to path analysis results, family ties had a significant negative predictive power on depression (ß = -0.225, P < .001), as did social support (ß = -0.978, P < .001). The predictive power of crisis episodes on depression through social support was 0.197 (-0.201 × -0.978 = 0.197, P < .001), and it was -0.324 (-0.331 × -0.978 = -0.324, P < .001) through social participation, which indicated that social support plays a mediating role between crisis episodes and depression and between social participation and depression.Strengthening effective protective factors can improve the resilience of elderly people and enable them to cope with dilemmas rapidly and effectively when faced with crisis episodes as well as restore their health status and enjoy a satisfactory life.


Asunto(s)
Depresión/epidemiología , Resiliencia Psicológica , Índice de Severidad de la Enfermedad , Anciano , Anciano de 80 o más Años , Estudios Transversales , Depresión/diagnóstico , Progresión de la Enfermedad , Femenino , Humanos , Estudios Longitudinales , Masculino , Factores Protectores , Apoyo Social , Taiwán/epidemiología
5.
Epidemiol Psychiatr Sci ; 29: e92, 2020 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-31928567

RESUMEN

AIMS: Research from high-income countries has implicated travel distance to mental health services as an important factor influencing treatment-seeking for mental disorders. This study aimed to test the extent to which travel distance to the nearest depression treatment provider is associated with treatment-seeking for depression in rural India. METHODS: We used data from a population-based survey of adults with probable depression (n = 568), and calculated travel distance from households to the nearest public depression treatment provider with network analysis using Geographic Information Systems (GIS). We tested the association between travel distance to the nearest public depression treatment provider and 12 month self-reported use of services for depression. RESULTS: We found no association between travel distance and the probability of seeking treatment for depression (OR 1.00, 95% CI 0.98-1.02, p = 0.78). Those living in the immediate vicinity of public depression treatment providers were just as unlikely to seek treatment as those living 20 km or more away by road. There was evidence of interaction effects by caste, employment status and perceived need for health care, but these effect sizes were generally small. CONCLUSIONS: Geographic accessibility - as measured by travel distance - is not the primary barrier to seeking treatment for depression in rural India. Reducing travel distance to public mental health services will not of itself reduce the depression treatment gap for depression, at least in this setting, and decisions about the best platform to deliver mental health services should not be made on this basis.


Asunto(s)
Depresión/terapia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Conducta de Búsqueda de Ayuda , Servicios de Salud Mental/estadística & datos numéricos , Aceptación de la Atención de Salud , Población Rural/estadística & datos numéricos , Viaje/estadística & datos numéricos , Adulto , Estudios Transversales , Depresión/diagnóstico , Depresión/psicología , Femenino , Sistemas de Información Geográfica , Encuestas de Atención de la Salud , Investigación sobre Servicios de Salud , Humanos , India , Masculino , Vigilancia de la Población , Factores de Tiempo
6.
Mymensingh Med J ; 29(1): 16-20, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915330

RESUMEN

Now a days depression is one of the leading cause of disabilities all over the world. Depression leads to a wide range of disorders and affects people of all communities. Medical students pass through a relatively high level of stress. Several studies revealed that anxiety and depression is significantly prevalent among medical students and often it persists even when they become physicians. The study was designed with an aim to estimate the prevalence of depression among the medical students of Bangladesh. The cross sectional descriptive type of observational study was conducted among randomly selected 399 Bangladeshi students of third year MBBS from six (6) randomly selected public medical colleges of Bangladesh from February 2017 to July 2017. Data were collected by a semi-structured self-administered questionnaire containing Beck's Depression Inventory. Data were entered and analyzed by SPSS version 20.0. Among 399 medical students, 45.6% were male and 54.4% were female. Regarding presence of depression among the medical students, 35.8% students had normal score. More than one fourth of the students (25.1%) had mild mood disturbance. Borderline clinical depression was found in 15.5% and moderate depression was found in 18.0% of the students. Severe depression was found in 5.3% students and one (0.3%) student was suffering from extreme depression. Overall 39.1% students were suffering from different levels of depression. Depression was prevalent more in female students (45.6%) than male students (31.3%). Suicidal tendency was present in 18.8% students. Among them 14.3% had thoughts of killing themselves but they would not carry them out; 3% would like to kill themselves and 1.5% would kill themselves if they had the chance. Suicidal tendency was also a bit higher in female students (19.3%) than male students (18.1%). A significant number (39.1%) of medical students of Bangladesh are suffering from depression and many of them (18.8%) have suicidal tendency which demands immediate attention of the authority. The findings of the study warrant a need for psychiatric counseling and support services for vulnerable students.


Asunto(s)
Depresión/epidemiología , Estudiantes de Medicina/psicología , Bangladesh/epidemiología , Estudios Transversales , Depresión/diagnóstico , Depresión/psicología , Femenino , Humanos , Masculino , Encuestas y Cuestionarios
7.
Mymensingh Med J ; 29(1): 177-182, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915355

RESUMEN

Global population is ageing and Bangladesh has one of the fastest growing ageing populations in this region. Growth in the elderly population relative to other age groups challenges existing health services, family relationships and social security. Combined with this, depression has become a major mental health problem for elderly people especially for urban elderly for nuclear family norm in urban areas. The study was descriptive type of cross-sectional in nature and was conducted in Rangpur Medical College Hospital, Rangpur & Prime Medical College Hospital, Rangpur, Bangladesh. The objective of this study was to assess the lifestyle and level of depression in urban elderly. Depression was measured by questionnaire of geriatric depression scale among 254 respondents. 87.8% of the respondents were age between 60-70 years. Majorities (63%) of the respondents were male, 54% of the respondents lived in nuclear type family and the rest (46%) in joint type of family. Among respondents near half (47.2%) of the respondents found Mild depressive, around one third (32.7%) were severe depressive, and the rest (20.1%) were normal. There was significant association between occupational status of the respondents and depression (x² = 45.600, df=14, p=0.000). Farmers unemployed found severely depressive (52.1%) followed by day-labourer (50%) and businessmen (37.5%). There was significant association between financial self dependency and depression of the respondents (x²= 34.072, df=4, p=0.000). Severe depression (43.8%) was found among those who were not financially self dependent. There was also significant association between monthly income and depression of the respondents (x²= 67.327, df=8, p=0.000). The study also found that lower income group (

Asunto(s)
Estilo de Vida , Población Urbana/estadística & datos numéricos , Anciano , Bangladesh/epidemiología , Estudios Transversales , Depresión/diagnóstico , Depresión/etnología , Depresión/psicología , Evaluación Geriátrica , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Factores Socioeconómicos , Encuestas y Cuestionarios
8.
Health Qual Life Outcomes ; 18(1): 9, 2020 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-31910859

RESUMEN

BACKGROUND: Anxiety and depression symptoms are common among cardiac patients. The Hospital Anxiety and Depression Scale (HADS) is frequently used to measure symptoms of anxiety and depression; however, no study on the validity and reliability of the scale in Danish cardiac patients has been done. The aim, therefore, was to evaluate the psychometric properties of HADS in a large sample of Danish patients with the four most common cardiac diagnoses: ischemic heart disease, arrhythmias, heart failure and heart valve disease. METHODS: The DenHeart study was designed as a national cross-sectional survey including the HADS, SF-12 and HeartQoL and combined with data from national registers. Psychometric evaluation included analyses of floor and ceiling effects, structural validity using both exploratory and confirmatory factor analysis and hypotheses testing of convergent and divergent validity by relating the HADS scores to the SF-12 and HeartQoL. Internal consistency reliability was evaluated by Cronbach's alpha, and differential item functioning by gender was examined using ordinal logistic regression. RESULTS: A total of 12,806 patients (response rate 51%) answered the HADS. Exploratory factor analysis supported the original two-factor structure of the HADS, while confirmatory factor analysis supported a three-factor structure consisting of the original depression subscale and two anxiety subscales as suggested in a previous study. There were floor effects on all items and ceiling effect on item 8. The hypotheses regarding convergent validity were confirmed but those regarding divergent validity for HADS-D were not. Internal consistency was good with a Cronbach's alpha of 0.87 for HADS-A and 0.82 for HADS-D. There were no indications of noticeable differential item functioning by gender for any items. CONCLUSIONS: The present study supported the evidence of convergent validity and high internal consistency for both HADS outcomes in a large sample of Danish patients with cardiac disease. There are, however, conflicting results regarding the factor structure of the scale consistent with previous research. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01926145.


Asunto(s)
Ansiedad/diagnóstico , Enfermedades Cardiovasculares/psicología , Depresión/diagnóstico , Calidad de Vida , Anciano , Ansiedad/epidemiología , Ansiedad/psicología , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Dinamarca/epidemiología , Depresión/psicología , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sistema de Registros , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
9.
Oral Dis ; 26(1): 96-110, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31650646

RESUMEN

OBJECTIVES: To validate the Hospital Anxiety and Depression Scale (HADS) and the 10-item Perceived Stress Scale (PSS-10) for use in patients with oral lichen planus (OLP) and to provide cross-sectional analysis of anxiety, depressive and distress symptoms in patients with OLP. METHODS: Validity and reliability of both instruments were assessed in 260 participants with OLP in one tertiary oral medicine centre through confirmatory factor analysis and calculation of reliability coefficients. Prevalence, clinical and demographic predictors of the presence of psychological symptoms in OLP were calculated and identified using multivariated logistic regression. RESULTS: Factor analysis results demonstrated that a bifactor model described the underlying structure of both scales better than other models. Values of omega indicated adequate reliability of total HADS and PSS-10 score while low coefficient omega hierarchical values limit clinical applicability of their subscale scores. The prevalence of anxiety, depressive and distress symptoms in OLP was 39.23%, 20.77% and 27.69%, respectively. Pain intensity, disease comorbidities, age, smoking and alcohol consumption were found to be independent predictors of the presence of psychological symptoms in OLP. CONCLUSION: The HADS and PSS-10 are appropriate to use as general measures of psychological distress and perceived stress in patients with OLP.


Asunto(s)
Liquen Plano Oral/psicología , Pruebas Psicológicas , Estrés Psicológico/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Ansiedad/diagnóstico , Estudios Transversales , Depresión/diagnóstico , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
10.
Psychiatr Hung ; 35(1): 58-67, 2020.
Artículo en Húngaro | MEDLINE | ID: mdl-31854323

RESUMEN

INTRODUCTION: Several long-term follow-up studies investigate the progression of adolescent onset major depressive disorder but much less explore short and long-term consequences and prognosis into adulthood of childhood- onset depression. The aim of the present study is to follow childhood-onset depression, lifetime comorbid psychiatric disorders and suicidal behavior into adulthood. METHODS: Subjects (N=166) were 25.95+2.42 years old on average, 54.2% were women. Follow-up period lasted for a mean of 14.74+1.31 years. Psychiatric diagnosis was assessed by a DSM-IV based semi-structured interview. Subjects reported on 4 stages of suicidal behavior as one of the symptoms of depressive disorder. RESULTS: The onset of the first depressive episode was at the mean age of 10.17+2.34 years. 40,4% of the sample had only 1 episode while recurrent depressive episode presented in 32.5% above 18 years of age. Lifetime comorbid psychiatric disorders were present in more than 1/3 of the sample. The most frequent lifetime comorbidity was anxiety (42.4%), and specific phobia among anxiety disorders. Lifetime attention deficit-hyperactivity disorder and oppositional/conduct disorder were also frequent (25.9% and 16.9%, respectively). Suicidal behavior was not present life-time in 19.1% of the sample. Thoughts of death and thoughts of suicide were quite frequent (80.8% and 69.5%, respectively), specific plans and suicidal attempt were more frequent in girls (plan:female vs male 53.9% vs 38.4%, attempt: 33.3% vs 9.6%) during follow-up. CONCLUSION: About one-third of childhood-onset depression had recurrence above 18 years of age, which is lower than the recurrence rate for adolescent onset depression. A high rate of lifetime comorbidity was found between depression and anxiety disorders. The assessment of the actual level of suicidal behavior is important in the prevention of selfdestructive behavior.


Asunto(s)
Depresión/diagnóstico , Depresión/psicología , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/psicología , Suicidio/psicología , Adolescente , Adulto , Edad de Inicio , Trastornos de Ansiedad/complicaciones , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/psicología , Niño , Comorbilidad , Depresión/complicaciones , Trastorno Depresivo Mayor/complicaciones , Femenino , Estudios de Seguimiento , Humanos , Masculino , Pronóstico , Factores de Riesgo , Adulto Joven
11.
Support Care Cancer ; 28(1): 55-64, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30980258

RESUMEN

PURPOSE: To facilitate access to and provision of psychosocial care to cancer patients in the community, the Cancer Support Community (CSC) developed CancerSupportSource® (CSS), an evidence-based psychosocial distress screening program. The current study examined the psychometric properties and multi-dimensionality of a revised 25-item version of CSS, and evaluated the scale's ability to identify individuals at risk for clinically significant levels of depression and anxiety. METHODS: CSS development and validation were completed in multiple phases. Exploratory factor analysis was completed with 1436 individuals diagnosed with cancer to examine scale dimensionality, and nonparametric receiver operating characteristic (ROC) curve analyses were used to determine scoring thresholds for depression and anxiety risk scales. Internal consistency reliability and convergent and discriminant validity were also examined. Confirmatory factor analysis and intraclass correlation coefficients were subsequently calculated with a separate sample of 1167 individuals to verify the scale factor structure and examine test-retest reliability. RESULTS: Five factors were identified and confirmed: (1) emotional well-being, (2) symptom burden and impact, (3) body image and healthy lifestyle, (4) health care team communication, and (5) relationships and intimacy. Psychometric evaluation of the total scale and factors revealed strong internal consistency reliability, test-retest reliability, and convergent and divergent validity. Sensitivity of CSS 2-item depression and 2-item anxiety risk scales were .91 and .92, respectively. CONCLUSIONS: Results indicate that CancerSupportSource is a reliable, valid, multi-dimensional distress screening program with the capacity to screen for those at risk for clinically significant levels of depression and anxiety.


Asunto(s)
Supervivientes de Cáncer/psicología , Tamizaje Masivo/métodos , Neoplasias/psicología , Psicometría/métodos , Estrés Psicológico/diagnóstico , Adulto , Anciano , Ansiedad/diagnóstico , Ansiedad/etiología , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/etiología , Depresión/diagnóstico , Depresión/etiología , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/etiología , Femenino , Humanos , Masculino , Tamizaje Masivo/normas , Persona de Mediana Edad , Neoplasias/complicaciones , Neoplasias/diagnóstico , Psicometría/normas , Reproducibilidad de los Resultados , Apoyo Social
12.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(9. Vyp. 2): 68-77, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31825393

RESUMEN

AIM: To develop a personalized approach to the appointment of a complex antidepressant therapy in combination with drugs of neuroprotective and neurotrophic action in depressed elderly patients based on the selection of predictors of low therapeutic response (LTR). MATERIAL AND METHODS: The study included 152 hospitalized patients, aged 60 years and older, with moderate and mild depression (ICD-10) who received monotherapy (44 people) with antidepressants of the new generation and complex therapy (108 people) with the same antidepressants in combination with neuroprotective drugs. In the monotherapy group, correlations between treatment efficacy (change in average total HAMD-17 scores) and a set of parameters, including socio-demographic data, results of psychopathological, somatic, standardized assessment and neuroimaging (CT) of the brain were analyzed. The validity of the established correlations as predictors of LTR was estimated based on a comparison of their frequency among the responders (≥50% reduction) and non-responders (<50% reduction). Comparison of the efficacy of therapy in groups of patients with mono - and complex therapy was carried out depending on the presence or absence of predictors of LTR. RESULTS: LTR predictors are living alone, complaints about memory loss and signs of pronounced diffuse lesions of the subcortical white matter of the brain, which are significantly more frequently observed in non-responders (p<0.05). The increase in the number of predictors (2 and more) correlates with a significant decrease in therapeutic efficacy (p<0.001). Patients with complex in structure and protracted depressions tend to decrease in efficiency, and in most of them (more than 87% of cases) LTR predictors are detected. In patients with LTR predictors, the complex therapy is significantly more effective than monotherapy, allowing in all cases to achieve 50% reduction of depressive symptoms by the 4th week of treatment. CONCLUSION: Personalized indications for the appointment of complex antidepressant therapy in combination with neuroprotective drugs in depressed elderly patients are formulated.


Asunto(s)
Antidepresivos , Depresión , Psicoterapia , Anciano , Depresión/diagnóstico , Humanos , Resultado del Tratamiento
13.
Ideggyogy Sz ; 72(11-12): 397-404, 2019 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-31834683

RESUMEN

Background and purpose: Migraine is one of the most disabling primary headache conditions. We aimed to detect hidden symptoms of anxiety and depression and to survey stress-coping mechanisms and related quality of life in a large migraine population without any known psychiatric comorbidity. Methods: 123 migraine patients (MG) and 66 healthy subjects (HC) completed the Beck Depression Inventory-II (BDI-II), the State and Trait Anxiety Inventory (S-STAI and T-STAI), the Stress and Coping Inventory (SCI) and the 36-Item Short Form Health Survey (SF-36). Results: MG patients reached significantly higher scores on the BDI-II and the T-STAI yielding previously undetected anxiety and depression symptoms. Significant differences were present on the SCI: higher stress scores and lower coping levels suggested impaired stress-coping strategies in migraine. MG patients achieved significantly lower scores on most of SF-36 subscales indicating lower perceived quality of life. Significant correlations were found between BDI-II, T-STAI, SCI scores and subscales of the SF-36. Conclusion: Unrecognized symptoms of anxiety and depression, as well as less effective stress-coping strategies might be related to the lower perceived quality of life in migraine. The screening of these symptoms might lead to more focused and efficient therapeutic strategies. Addressing stress management techniques could improve quality of life on the long-term.


Asunto(s)
Adaptación Psicológica , Ansiedad/epidemiología , Depresión/epidemiología , Trastornos Migrañosos/psicología , Calidad de Vida/psicología , Ansiedad/diagnóstico , Ansiedad/psicología , Comorbilidad , Depresión/diagnóstico , Depresión/psicología , Humanos , Trastornos Migrañosos/epidemiología , Escalas de Valoración Psiquiátrica , Estrés Psicológico
14.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(11): 116-122, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31851182

RESUMEN

Anhedonia is one of the core features of depression. The article considers the place of anhedonia in the structure of affective disorders, its influence on the prognosis and effectiveness of therapy. The authors stress that various manifestations of anhedonia must be considered in correlation with the basic ability to feel pleasure. Therapy of anhedonia is not always effective. According to literature, agomelatin occupies a leading position among the drugs that reduce anhedonia.


Asunto(s)
Anhedonia , Trastorno Depresivo , Depresión/complicaciones , Depresión/diagnóstico , Trastorno Depresivo/complicaciones , Trastorno Depresivo/diagnóstico , Emociones , Humanos , Pronóstico
15.
Epidemiol Psychiatr Sci ; 29: e79, 2019 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-31841104

RESUMEN

In March 2019, the US Food and Drug Administration (FDA) approved a nasal spray formulation of esketamine for the treatment of resistant depression in adults. Esketamine is the S-enantiomer of ketamine, an FDA-approved anaesthetic, known to cause dissociation and, occasionally, hallucinations. While ketamine has not been approved for depression in the USA or in any other country, it has been used off-label in cases of severe depression. This commentary critically reviewed the evidence on esketamine submitted to the FDA, aiming to draw implications for clinical practice, research and regulatory science.


Asunto(s)
Antidepresivos/uso terapéutico , Depresión/tratamiento farmacológico , Trastorno Depresivo Resistente al Tratamiento/tratamiento farmacológico , Ketamina/uso terapéutico , Adulto , Antidepresivos/administración & dosificación , Depresión/diagnóstico , Trastorno Depresivo Resistente al Tratamiento/diagnóstico , Aprobación de Drogas , Medicina Basada en la Evidencia , Humanos , Infusiones Intravenosas , Ketamina/administración & dosificación , Estados Unidos , United States Food and Drug Administration
16.
BMC Public Health ; 19(1): 1464, 2019 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-31694584

RESUMEN

BACKGROUND: Chronic heart failure patients typically suffer from tremendous strain and are managed mainly in primary care. New care concepts adapted to the severity of heart failure are a challenge and need to consider health-related quality of life aspects. This is the first psychometric validation of the German EQ-5D-5L™ as a generic instrument for assessing health-related quality of life (HRQOL) in a primary care heart failure patient sample. METHODS: Confirmatory factor analysis (CFA) was performed on the baseline EQ-5D-5L™ data from the RECODE-HF study (responses to all items from n = 3225 of 3778 patients). Basic CFA models for HRQOL were calculated based on the EQ-5D-5L™ items using the maximum likelihood (ML) and the asymptotic distribution-free method. In an extended CFA, physical activity and depression were added. The basic CFA ML model was verified for the reduced number of cases of the extended CFA model (n = 3064). In analyses of variance the association of the EQ-5D-5L™ visual analogue scale (VAS) and both the German and the British EQ-5D-5L™ crosswalk index with the SF-36 measure of general health were examined. The discriminant validity was analysed using Pearson's chi-squared tests applying the New York Heart Association classification, for the VAS and indices analyses of variance were calculated. RESULTS: In the basic CFA models the root mean square error of approximation was 0.095 with the ML method, and 0.081 with the asymptotic distribution-free method (Comparative Fit Index > 0.90 for both). Physical activity and depression were confirmed as influential factors in the extended model. The VAS and indices were strongly associated with the SF-36 measure of general health (partial eta-squared 0.525/0.454/0.481; all p <  0.001; n = 3155/3210/3210, respectively), also for physical activity and depression when included together (partial eta-squared 0.050, 0.200/0.047, 0.213/0.051 and 0.270; all p <  0.001; n = 3015/n = 3064/n = 3064, respectively). The discriminant validity analyses showed p-values < 0.001 and small to moderate effect sizes for all EQ-5D-5L™ items. Analyses of variance demonstrated moderate effect sizes for the VAS and indices (0.067/0.087/0.084; all p <  0.001; n = 3110/3171/3171). CONCLUSION: The German EQ-5D-5L™ is a suitable method for assessing HRQOL in heart failure patients.


Asunto(s)
Insuficiencia Cardíaca/psicología , Calidad de Vida , Encuestas y Cuestionarios/normas , Adulto , Anciano , Enfermedad Crónica , Depresión/diagnóstico , Depresión/etiología , Ejercicio/psicología , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Traducciones
17.
Cyberpsychol Behav Soc Netw ; 22(11): 692-699, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31697601

RESUMEN

In a two-wave, 4-month longitudinal study of 308 adults, two hypotheses were tested regarding the relation of Twitter-based measures of online social media use and in-person social support with depressive thoughts and symptoms. For four of five measures, Twitter use by in-person social support interactions predicted residualized change in depression-related outcomes over time; these results supported a corollary of the social compensation hypothesis that social media use is associated with greater benefits for people with lower in-person social support. In particular, having a larger Twitter social network (i.e., following and being followed by more people) and being more active in that network (i.e., sending and receiving more tweets) are especially helpful to people who have lower levels of in-person social support. For the fifth measure (the sentiment of Tweets), no interaction emerged; however, a beneficial main effect offset the adverse main effect of low in-person social support.


Asunto(s)
Depresión/diagnóstico , Relaciones Interpersonales , Medios de Comunicación Sociales , Apoyo Social , Adulto , Depresión/psicología , Femenino , Humanos , Estudios Longitudinales , Masculino , Índice de Severidad de la Enfermedad , Adulto Joven
18.
Nurs Clin North Am ; 54(4): 457-471, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31703773

RESUMEN

Depression management in primary care settings is the norm, in the United States and globally. As incidence and prevalence of depression continue to mount, there are innovative models of treatment, newer understandings, more open philosophies, and evidence-informed treatments that may address this troubling public health issue. This article attempts to succinctly examine the evidence in identifying and treating this in the United States in an expedient, evidence-informed manner to assist those in need of have care that is patient centered, of high quality, affordable, and readily accessible across the lifespan.


Asunto(s)
Depresión/diagnóstico , Depresión/terapia , Atención Dirigida al Paciente , Atención Primaria de Salud/organización & administración , Humanos , Telemedicina , Estados Unidos
19.
Spine (Phila Pa 1976) ; 44(23): 1647-1652, 2019 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-31725687

RESUMEN

STUDY DESIGN: Retrospective review of a prospectively collected multicenter database. OBJECTIVE: The aim of this study was to investigate factors associated with low preoperative SRS pain scores. SUMMARY OF BACKGROUND DATA: The prevalence of preoperative pain in patients with adolescent idiopathic scoliosis (AIS) has become increasingly evident and is a primary concern for patients and families. Greater preoperative pain is associated with more postoperative pain; however, less is understood about what contributes to preoperative pain. METHODS: A prospectively collected, multicenter database was queried for patients with AIS. Patients were divided into 2 cohorts based on preoperative SRS pain scores: ≤ 3 (Pain cohort), 4 to 5 (No Pain cohort). Univariate analysis was performed identifying which factors were associated with a low preoperative SRS score and used for a CART analysis. RESULTS: Of 2585 patients total, 2141 (83%) patients had SRS pain scores of 4 to 5 (No Pain) and 444 (17%) had SRS pain scores ≤3 (Pain). Female sex, older age, greater % body mass index, larger lumbar curves, greater T5-12 kyphosis, and lower mental health scores were associated with greater preoperative pain. In multivariate CART analysis, lower mental health SRS scores (P = 0.04) and older age (P = 0.003) remained significant, with mental health scores having the greatest contribution. In subdividing the mental health component questions, anxiety-related questions appeared to have the greatest effect followed by mood/depression (SRS Question 13: OR 2.04; Q16: OR 1.35; Q7: OR 1.31; Q3: OR 1.20). CONCLUSION: Anxiety and mood are potentially modifiable risk factors that have the greatest impact on pre- and postoperative pain. These results can be used to identify higher-risk patients and develop preoperative therapeutic protocols to improve postoperative outcomes. LEVEL OF EVIDENCE: 3.


Asunto(s)
Salud Mental , Dimensión del Dolor/psicología , Dolor Postoperatorio/psicología , Cuidados Preoperatorios/psicología , Escoliosis/psicología , Escoliosis/cirugía , Adolescente , Estudios de Cohortes , Depresión/diagnóstico , Depresión/psicología , Depresión/cirugía , Femenino , Humanos , Masculino , Dimensión del Dolor/métodos , Dolor Postoperatorio/diagnóstico , Cuidados Preoperatorios/métodos , Estudios Prospectivos , Estudios Retrospectivos , Escoliosis/diagnóstico , Resultado del Tratamiento , Adulto Joven
20.
Presse Med ; 48(11 Pt 1): 1306-1318, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31732367

RESUMEN

CONTEXT: Bipolar disorder (BD) is a severe and recurrent mood disorder. It is characterized by episodic changes in mood and energy/activity levels that are increased during mania/hypomania or decreased during depression. Recurrent mania (RM) is a mood disorder, which would be defined by at least two manic/hypomanic without depressive episodes. Despite a rich body of clinical descriptions, RM is still not integrated into the latest editions of disease classifications and continues to be subsumed under BD in clinical practice. OBJECTIVES: We conducted a systematic review of the literature to pool data about RM prevalence within BD groups, identify differences between RM and BD and develop reliable knowledge about specificities of RM. Furthermore, we sought to identify the methodological bias inherent to RM studies. METHOD: Relevant publications were identified by a systematic search of PubMed, Embase, ScienceDirect and PsychInfo databases according to PRISMA criteria, with no limitation of date. The following MESH terms were used: (mania OR manic) AND (unipolar) NOT (depress*) OR ("unipolar mania" OR "unipolar manic" NOT "depress*"). RESULTS: Twenty-three (23) of 186identified studies met eligibility criteria for our systematic review. The total sample included 1118RM subjects among 4796BD subjects. The weighted mean of RM prevalence was 23.2%. Compared to BD, RM was characterized by a predominance of men, an earlier age at illness onset, less rapid cycles and seasonal variations, longer manic episodes, less specific clinical features (suicide attempts, anxious disorders, catatonic symptoms, irritability, hyperactivity, racing thoughts), less family history of depression, more addictive comorbidities and worse response to lithium prophylaxis (P<0.05). However, many studies failed to replicate these significant differences. LIMITS: RM studies were mainly retrospective. The major bias of RM studies were the lack of consensus on the defining criteria for RM and the risk of unreported depressive episodes, both in charts that were reviewed in retrospective studies and in prospective studies with insufficient follow-up duration. CONCLUSION: Although the literature on RM remains sparse, many authors agree that RM should be distinguished from BD. RM would concern almost 1 in 4 BD patients. Furthermore, several clinical variables could differentiate this mood disease from BD and may orient the specific therapeutic choice. However, clinical criteria are still not reliable enough to make a diagnosis of RM. Further studies are required to replicate the results of existing studies and to adjust for the effect of methodological biases.


Asunto(s)
Trastorno Bipolar/diagnóstico , Depresión/diagnóstico , Trastorno Bipolar/tratamiento farmacológico , Trastorno Bipolar/epidemiología , Trastorno Bipolar/psicología , Depresión/psicología , Diagnóstico Diferencial , Femenino , Humanos , Compuestos de Litio/uso terapéutico , Masculino , Prevalencia , Estudios Prospectivos , Recurrencia , Estudios Retrospectivos
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