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1.
Sensors (Basel) ; 21(9)2021 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-33946664

RESUMEN

BACKGROUND: Social isolation during COVID-19 may negatively impact older adults' wellbeing. To assess its impact, we measured changes in physical activity and sleep among community-dwelling older adults, from pre-to post-pandemic declaration. METHOD: Physical activity and sleep in older adults (n = 10, age = 77.3 ± 1.9 years, female = 40%) were remotely assessed within 3-month pre-to 6-month post-pandemic declaration using a pendant-wearable system. Depression was assessed pre-and post-pandemic declaration using the Center for Epidemiologic Studies Depression scale and was compared with 48 h continuous physical activity monitoring data before and during pandemic. RESULTS: Compared to pre-pandemic, post-pandemic time spent in standing declined by 32.7% (Cohen's d = 0.78, p < 0.01), walking by 52.2% (d = 1.1, p < 0.01), step-counts by 55.1% (d = 1.0, p = 0.016), and postural transitions by 44.6% (d = 0.82, p = 0.017) with increase in sitting duration by 20.5% (d = 0.5, p = 0.049). Depression symptoms increased by 150% (d = 0.8, p = 0.046). Interestingly, increase in depression was significantly correlated with unbroken-prolong sitting bout (ρ = 0.677, p = 0.032), cadence (ρ = -0.70, p = 0.024), and sleep duration (ρ = -0.72, p = 0.019). CONCLUSION: This is one of the early longitudinal studies highlighting adverse effect of the pandemic on objectively assessed physical activity and sleep in older adults. Our observations showed need for timely intervention to mitigate hard to reverse consequences of decreased physical activity such as depression.


Asunto(s)
Dispositivos Electrónicos Vestibles , Anciano , Depresión/diagnóstico , Depresión/epidemiología , Femenino , Humanos , Pandemias
2.
Ann Acad Med Singap ; 50(3): 203-211, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33855316

RESUMEN

INTRODUCTION: Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19) are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic on HCWs in a national paediatric referral centre. METHODS: This was a survey-based study that collected demographic, work environment and mental health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis was performed to identify risk factors associated with psychological distress. RESULTS: The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%), respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%) and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors for poor psychological outcome. CONCLUSION: A high prevalence of depression, anxiety and stress was reported among frontline paediatric HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health professionals to plan and coordinate psychological intervention for the country should be considered.


Asunto(s)
Ansiedad/etiología , Depresión/etiología , Hospitales Pediátricos , Enfermedades Profesionales/etiología , Personal de Hospital/psicología , Estrés Psicológico/etiología , Adulto , Ansiedad/diagnóstico , Ansiedad/epidemiología , /prevención & control , Depresión/diagnóstico , Depresión/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/epidemiología , Pandemias , Prevalencia , Factores de Riesgo , Autoinforme , Índice de Severidad de la Enfermedad , Singapur/epidemiología , Estrés Psicológico/diagnóstico , Estrés Psicológico/epidemiología
3.
Adv Exp Med Biol ; 1305: 175-202, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33834401

RESUMEN

Depression is heterogeneous and complex disease with diverse symptoms. Its neurobiological underpinning is still not completely understood. For now, there are still no validated, easy obtainable, clinically useful noninvasive biomarker(s) or biomarker panel that will be able to confirm a diagnosis of depression, its subtypes and improve diagnostic procedures. Future multimodal preclinical and clinical research that involves (epi)genetic, molecular, cellular, imaging, and other studies is necessary to advance our understanding of the role of monoamines, GABA, HPA axis, neurotrophins, metabolome, and glycome in the pathogenesis of depression and their potential as diagnostic, prognostic, and treatment response biomarkers. These studies should be focused to include the first-episode depression and antidepressant drug-naïve patients with large sample sizes to reduce variability in different biological and clinical parameters. At present, metabolomics study revealed with high precision that a neurometabolite panel consisting of plasma metabolite biomarkers (GABA, dopamine, tyramine, kynurenine) might represent clinically useful biomarkers of MDD.


Asunto(s)
Trastorno Depresivo Mayor , Sistema Hipotálamo-Hipofisario , Biomarcadores , Depresión/diagnóstico , Trastorno Depresivo Mayor/diagnóstico , Humanos , Sistema Hipófiso-Suprarrenal
4.
Artículo en Ruso | MEDLINE | ID: mdl-33834726

RESUMEN

OBJECTIVE: To assess the mental health of health workers during a pandemic. MATERIAL AND METHODS: Eight hundred and twelve medical workers took part in a cross-sectional Internet survey. The questionnaire included a socio-demographic block, a block of questionnaires for assessing the level of symptoms of anxiety and depression (PHQ-9 and GAD-7). The data were processed using statistical methods. RESULTS: The prevalence of anxiety and depression among healthcare providers during the pandemic was 48.77% and 57.63% respectively. Subjectively poor quality of sleep was noted by 37.4% of respondents. Cluster analysis distinguished 4 groups of respondents: group 1 was characterized by high scores on PHQ-9 and GAD-7 and a low subjective assessment of sleep quality; group 2 had low scores on PHQ-9 and GAD-7 and a high subjective assessment of sleep quality; respondents from clusters 3 and 4 had average total scores on PHQ-9 and GAD-7, however, group 4 was characterized by significantly lower values of subjective sleep quality assessment. CONCLUSION: The division into clusters makes it possible to understand which groups of medical workers require psychological (psychotherapeutic) support in the first place. Cluster 1 respondents with high levels of anxiety and depression, as well as poor sleep quality, need priority assistance.


Asunto(s)
Pandemias , Ansiedad/diagnóstico , Ansiedad/epidemiología , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Personal de Salud , Humanos , Salud Mental , Federación de Rusia/epidemiología , Encuestas y Cuestionarios
5.
BMC Geriatr ; 21(1): 256, 2021 04 17.
Artículo en Inglés | MEDLINE | ID: mdl-33865312

RESUMEN

BACKGROUND: Readmission is related to high cost, high burden, and high risk for mortality in geriatric patients. A scoring system can be developed to predict the readmission of older inpatients to perform earlier interventions and prevent readmission. METHODS: We followed prospectively inpatients aged 60 years and older for 30 days, with initial comprehensive geriatric assessment (CGA) on admission in a tertiary referral centre. Patients were assessed with CGA tools consisting of FRAIL scale (fatigue, resistance, ambulation, illness, loss of weight), the 15-item Geriatric Depression Scale, Mini Nutritional Assessment short-form (MNA-SF), the Barthel index for activities of daily living (ADL), Charlson Comorbidity Index (CCI), caregiver burden based on 4-item Zarit Burden Index (ZBI), and cognitive problem with Abbreviated Mental Test (AMT). Demographic data, malignancy diagnosis, and number of drugs were also recorded. We excluded data of deceased patients and patients transferred to other hospitals. We conducted stepwise multivariate regression analysis to develop the scoring system. RESULTS: Thirty-day unplanned readmission rate was 37.6 %. Among 266 patients, 64.7 % of them were malnourished, and 46.5 % of them were readmitted. About 24 % were at risk for depression or having depressed mood, and 53.1 % of them were readmitted. In multivariate analysis, nutritional status (OR 2.152, 95 %CI 1.151-4.024), depression status (OR 1.884, 95 %CI 1.071-3.314), malignancy (OR 1.863 95 %CI 1.005-3.451), and functional status (OR 1.584, 95 %CI 0.885-2.835) were included in derivation of 7 score system. The scoring system had maximum score of 7 and incorporated malnutrition (2 points), depression (2 points), malignancy (2 points), and dependent functional status (1 point). A score of 3 or higher suggested 82 % probability of readmission within 30 days following discharge. Area under the curve (AUC) was 0.694 (p = 0.001). CONCLUSIONS: Malnutrition, depression, malignancy and functional problem are predictors for 30-day readmission. A practical CGA-based 7 scoring system had moderate accuracy and strong calibration in predicting 30-day unplanned readmission for older patients.


Asunto(s)
Desnutrición , Readmisión del Paciente , Actividades Cotidianas , Anciano , Depresión/diagnóstico , Depresión/epidemiología , Evaluación Geriátrica , Humanos , Desnutrición/diagnóstico , Desnutrición/epidemiología , Persona de Mediana Edad , Evaluación Nutricional , Estado Nutricional , Estudios Prospectivos , Factores de Riesgo
6.
BMC Geriatr ; 21(1): 259, 2021 04 17.
Artículo en Inglés | MEDLINE | ID: mdl-33865321

RESUMEN

BACKGROUND: Depression is a common mental disorder among older people. This study aimed to assess the association between housing environment factors and depressive symptoms among older people using a multidimensional assessment method. METHODS: The study uses a population-based cross-sectional design. A total of 950 participants aged ≥ 60 years were selected using a complex multistage sampling design from 22 locations in China. All data were collected using questionnaires by face-to-face interviews. A total of 938 participants were included in the analysis, and 17.1% of males and 23.1% of females were identified as having depressive symptoms. The depressive symptoms were assessed using the 15-item Geriatric Depression Scale. The housing environment was assessed on the basis of four dimensions: physical, social, psychological, and cognition and physical function. Cumulative logistic regression analysis was used to evaluate the association between housing environment and depressive symptoms. RESULTS: The Cochran-Armitage trend test showed that the depressive symptom scores were linearly negatively associated with self-assessed housing environment, living arrangement, life satisfaction, and other physical environment factors and linearly positively associated with cognitive and physical function scores. The results of cumulative logistic regression analysis showed that the housing environment was significantly associated with depressive symptoms. The participants' self-assessed housing environment was strongly associated with the levels of depressive symptom scores, and the odds ratio was 3.47 (95% CI, 1.14-10.82, P = 0.003). CONCLUSION: The housing environment was significantly associated with depressive symptoms. Our results suggest that multi-dimensional assessment in the housing environment may be an effective way to develop intervention strategies of depressive symptoms among older people.


Asunto(s)
Depresión , Vivienda , Anciano , Anciano de 80 o más Años , China/epidemiología , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Femenino , Evaluación Geriátrica , Humanos , Masculino , Encuestas y Cuestionarios
7.
BMC Psychiatry ; 21(1): 197, 2021 04 19.
Artículo en Inglés | MEDLINE | ID: mdl-33874939

RESUMEN

BACKGROUND: The Centre for Epidemiologic Studies Depression Scale (CES-D) is a commonly used psychometric scale of depression. A four-factor structure (depressed affect, positive affect, somatic symptoms, and interpersonal difficulties) was initially identified in an American sample aged 18 to 65. Despite emerging evidence, a latent structure has not been established in adolescents. This review aimed to investigate the factor structure of the CES-D in adolescents. METHODS: We searched Web of Science, PsychINFO and Scopus and included peer-reviewed, original studies assessing the factor structure of the 20-item CES-D in adolescents aged ≤18. Two independent researchers screened results and extracted data. RESULTS: Thirteen studies met the inclusion criteria and were primarily from school-based samples in the USA or Asia. Studies that conducted confirmatory factor analysis (CFA; n = 9) reported a four-factor structure consistent with the original factor structure; these studies were primarily USA-based. Conversely, studies that conducted exploratory factor analysis (EFA) reported distinct two or three factor structures (n = 4) and were primarily based in Asia. LIMITATIONS: Studies in a non-English language and those that included individuals aged > 18 years were excluded. Ethnic or cultural differences as well as different analytical methods impacted generalisability of results. The use of CFA as the primary analysis may have biased towards a four-factor structure. CONCLUSIONS: A four-factor CES-D structure was an appropriate fit for adolescents in Western countries; further research is required to determine the fit in in Asian countries. This has important implications for clinical use of the scale. Future research should consider how cultural differences shape the experience of depression in adolescents.


Asunto(s)
Depresión , Grupos Étnicos , Adolescente , Adulto , Anciano , Asia , Depresión/diagnóstico , Depresión/epidemiología , Estudios Epidemiológicos , Análisis Factorial , Humanos , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Psicometría , Reproducibilidad de los Resultados , Adulto Joven
8.
BMC Geriatr ; 21(1): 264, 2021 04 21.
Artículo en Inglés | MEDLINE | ID: mdl-33882865

RESUMEN

BACKGROUND: Prior studies on health disparity have shown that socioeconomic status is critical to inequality of health outcomes such as depression. However, two questions await further investigation: whether disparity in depression correlated with socioeconomic status will become larger when depression becomes severer, and whether digital technology will reduce the disparity in depression correlated with socioeconomic status. Our study aims to answer the above two questions. METHODS: By using the dataset from China Health and Retirement Longitudinal Study 2015, we use quantile regression models to examine the association between socioeconomic status and depression across different quantiles, and test the moderating effect of digital technology. RESULTS: Our study obtains four key findings. First, the negative effects of socioeconomic status on depression present an increasing trend at high quantiles. Second, Internet usage exacerbates the disparity in depression associated with education level on average, but reduces this disparity associated with education level at high quantiles. Third, Internet usage reduces the disparity in depression associated with income on average and at high quantiles. Fourth, mobile phone ownership has almost no moderating effect on the relationship between socioeconomic status and depression. CONCLUSIONS: Our findings suggest the potential use of digital technology in reducing disparity in depression correlated with socioeconomic status among middle-aged and aged individuals in developing countries.


Asunto(s)
Depresión , Anciano , China/epidemiología , Depresión/diagnóstico , Depresión/epidemiología , Depresión/terapia , Disparidades en el Estado de Salud , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Clase Social , Factores Socioeconómicos
9.
Nephrol Nurs J ; 48(2): 147-167, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33886245

RESUMEN

Depression is undertreated in patients with chronic kidney disease (CKD) stage 4 without kidney replacement therapy (KRT), despite evidence showing its association with an increase in morbidity and mortality. Earlier and more adequate identification of patients with depression is needed. A quasi-experimental evidence-based project included 33 patients with CKD stage 4 not on KRT from a local nephrology office. The patients, who had previously been screened with the Patient Health Questionnaire-2 (PHQ-2), were screened with the Beck Depression Inventory. Nine patients (27%) had Beck Depression Inventory scores suggesting the need for a mental health referral compared to none having the need for a mental health referral captured by the PHQ-2. Results of this study indicate that screening with the Beck Depression Inventory should be considered to more accurately identify patients with depressive symptoms so interventions can occur earlier.


Asunto(s)
Nefrología , Insuficiencia Renal Crónica , Depresión/diagnóstico , Depresión/etiología , Humanos , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/terapia , Terapia de Reemplazo Renal
10.
BMC Psychiatry ; 21(1): 205, 2021 04 22.
Artículo en Inglés | MEDLINE | ID: mdl-33888072

RESUMEN

BACKGROUND: Depression, a common worldwide mental disorder, which brings huge challenges to family and social burden around the world is different from fluctuant emotion and psychological pressure in their daily life. Although body signs have been shown to present manifestations of depression in general, few researches focus on whole body kinematic cues with the help of machine learning methods to aid depression recognition. Using the Kinect V2 device to record participants' simple kinematic skeleton data of the participant's body joints, the presented spatial features and low-level features is directly extracted from the record original Kinect-3D coordinates. This research aimed to constructed machine learning model with the preprocessed data importing, which could be used for depression automatic classification. METHODS: Considering some patients' conditions and current status and refer to psychiatrists' advices, simple and significant designed stimulus task will lead human skeleton data collection job. With original Kinect skeleton data extracting and preprocessing, the proposed experiment demonstrated four strong machine learning tools: Support Vector Machine, Logistic Regression, Random Forest and Gradient Boosting. Using the precision, recall, sensitivity, specificity, roc-curve, confusion matrix et.al, indicators were calculated as the measurement of methods, which were commonly used to evaluate classification methodologies. RESULTS: Across screened 64 pairs with age and gender totally matching in depression and control group, and Gradient Boosting achieved the best performance with the prediction accuracy of 76.92%. Sorted by female (54.69%) and male for the gender-based depression recognition, we applied best performance classifier Gradient Boosting got prediction accuracy of 66.67% in the male group, and 71.73% in the female group. Utilizing the best model Gradient Boosting for age-based classification, prediction accuracy got 76.92% in the older group (age >40, 50% of total) and 53.85% accuracy in the younger group (age <= 40). CONCLUSION: The depression and non-depression individuals can be well classified by computational models using Kinect captured skeletal data. The Gradient Boosting, an excellent machine learning tool, get the performance in the four methods we demonstrated. Meanwhile, in the gender-based depression classification also gets reasonable accuracy. In particular, the recognition results of the old group are significantly better than that of the young group. All these findings suggest that kinematic skeletal data based depression recognition can be applied as an effective tool for assisting in depression analysis.


Asunto(s)
Depresión , Aprendizaje Automático , Fenómenos Biomecánicos , Depresión/diagnóstico , Femenino , Humanos , Modelos Logísticos , Masculino , Máquina de Vectores de Soporte
11.
BMC Geriatr ; 21(1): 272, 2021 04 23.
Artículo en Inglés | MEDLINE | ID: mdl-33892638

RESUMEN

BACKGROUND: Depression and suicide rates are relatively high in the colder regions of Russia. Older individuals in these regions are especially susceptible to these issues and are understudied in this regard. This study aims to better understand the current depression prevalence, and the factors related to depression, among the older individuals in these colder regions of Russia by studying a population in Novosibirsk oblast. METHODS: A questionnaire survey was administered to 422 older individuals, assessing basic attributes and health status, and employing the following standardized scales: 8-item Short-Form Health Survey, Pittsburgh Sleep Quality Index, and 15-item Geriatric Depression Scale (GDS). Participants were divided in two groups (GDS ≤ 6, GDS > 6) and compared, using Student's t test, χ2 test, and logistic regression analysis. RESULTS: Young old (YO) adults showed significant correlation of depression with asthma (P = 0.005, OR = 6.40, 95%CI: 1.74-23.5), having a spouse (P = 0.016, OR = 1.99, 95%CI: 1.14-3.48), and daily communication with others (P < 0.001, OR = 0.336, 95%CI: 0.197-0.572). Among old old (OO) adults, significant correlation with depression was found for the variables work status (P = 0.047, OR = 0.115, 95%CI: 0.014-0.974), and weekly walking (P = 0.014, OR = 0.288, 95%CI: 0.106-0.778). CONCLUSIONS: Twenty eight percent of the participants have depression. In YO adults, frequent communication and social ties with individuals outside of the family can mitigate depression prevalence. As for OO adults, the factors that have the highest impact on mitigating depression are related to daily activity, including both frequent walking and working or self-employment. Asthma patients are one of the more sensitive groups towards depression, but further research on this topic is needed.


Asunto(s)
Actividades Cotidianas , Depresión , Anciano , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Evaluación Geriátrica , Humanos , Federación de Rusia/epidemiología , Siberia/epidemiología
12.
Artículo en Inglés | MEDLINE | ID: mdl-33804879

RESUMEN

(1) Background: The Patient Health Questionnaire-9 (PHQ-9) is a tool that screens patients for depression in primary care settings. In this study, we evaluated the efficacy of PHQ-9 in evaluating suicidal ideation (2) Methods: A total of 8760 completed questionnaires collected from college students were analyzed. The PHQ-9 was scored in combination with and evaluated against four categories (PHQ-2, PHQ-8, PHQ-9, and PHQ-10). Suicidal ideations were evaluated using the Mini-International Neuropsychiatric Interview suicidality module. Analyses used suicide ideation as the dependent variable, and machine learning (ML) algorithms, k-nearest neighbors, linear discriminant analysis (LDA), and random forest. (3) Results: Random forest application using the nine items of the PHQ-9 revealed an excellent area under the curve with a value of 0.841, with 94.3% accuracy. The positive and negative predictive values were 84.95% (95% CI = 76.03-91.52) and 95.54% (95% CI = 94.42-96.48), respectively. (4) Conclusion: This study confirmed that ML algorithms using PHQ-9 in the primary care field are reliably accurate in screening individuals with suicidal ideation.


Asunto(s)
Cuestionario de Salud del Paciente , Ideación Suicida , Depresión/diagnóstico , Humanos , Aprendizaje Automático , Tamizaje Masivo , Escalas de Valoración Psiquiátrica , Encuestas y Cuestionarios
13.
Ann Clin Psychiatry ; 33(2): 101-107, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33878284

RESUMEN

BACKGROUND: The COVID-19 pandemic may adversely impact the mental health of health care workers (HCWs). To address this issue, it is essential to determine levels of anxiety, depression, and traumatic stress, and sources of stress, and to identify subgroups of HCWs at a higher risk of adverse mental health outcomes during the COVID-19 pandemic. METHODS: We conducted a cross-sectional study of symptoms of mental illness in HCWs in the area surrounding Detroit, Michigan. The online survey included questions about demographics, health and clinical factors, and sources of stress. Several tools were used to assess psychiatric symptoms among HCWs, including the Perceived Stress Scale, the Patient Health Questionnaire depression scale, the Generalized Anxiety Disorder 7-item assessment, and the Posttraumatic Stress Disorder Checklist for DSM-5. The adequacy of personal protective equipment, patient resources, and training for highly contagious diseases were rated. RESULTS: The sample (N = 129) was predominantly female (51.2%) and White (65.9%), with 30.2% screening positive for clinical follow-up to assess anxiety, 20.9% for moderate to severe depression, and 16.3% for elevated traumatic stress. Differences were found by self-reported psychiatric diagnosis and chronic conditions, and role on treatment teams. CONCLUSIONS: Frontline HCWs demonstrate high levels of stress and trauma symptoms. Timely screening and accommodations may be needed during health care crises, such as the COVID-19 pandemic.


Asunto(s)
Personal de Salud , Estrés Laboral , Estrés Psicológico , Adulto , Ansiedad/diagnóstico , Ansiedad/etiología , /psicología , Estudios Transversales , Depresión/diagnóstico , Depresión/etiología , Femenino , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Humanos , Masculino , Salud Mental/estadística & datos numéricos , Michigan/epidemiología , Evaluación de Necesidades , Salud Laboral/estadística & datos numéricos , Estrés Laboral/diagnóstico , Estrés Laboral/epidemiología , Estrés Laboral/etiología , Estrés Laboral/psicología , Escalas de Valoración Psiquiátrica , Trastornos de Estrés Traumático/etiología , Trastornos de Estrés Traumático/prevención & control , Estrés Psicológico/diagnóstico , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Estrés Psicológico/psicología
14.
BMC Psychiatry ; 21(1): 187, 2021 04 09.
Artículo en Inglés | MEDLINE | ID: mdl-33836699

RESUMEN

BACKGROUND: Witnessing delirium can be distressing for family caregivers (i.e., relatives or friends) of critically ill patients. This study aimed to evaluate associations between caregiver-detected delirium in critically ill patients and depression and anxiety symptoms in their family caregivers. METHODS: Consecutive adult patient-caregiver dyads were enrolled from a 28-bed medical-surgical intensive care unit. Patient delirium was screened for daily by family caregivers using the Sour Seven instrument. Family caregivers completed the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) instruments daily to assess their own depression and anxiety symptoms. Response feature analysis was used to handle repeated measures. Descriptive statistics and regression analyses were completed. RESULTS: One hundred forty-seven patient-caregiver dyads were enrolled. Clinically significant symptoms of depression and anxiety occurred in 27% and 35% of family caregivers, respectively. Caregiver-detected delirium occurred in 65% of patients, and was not associated with clinically significant caregiver depression (Odds Ratio [OR] 1.4, 95% Confidence Interval [95%CI] 0.6-3.1) or anxiety (OR 1.2, 95%CI 0.6-2.6) symptoms. When stratified by Sour Seven scores, scores 1-3 and 4-9 were associated with increased symptoms of anxiety (OR 3.1, 95%CI 1.3-7.0) and depression (OR 2.6, 95%CI 1.1-6.1) in family caregivers. Caregiver-detected delirium score was associated with severity of family caregiver anxiety symptoms (coefficient 0.2, 95%CI 0.1-0.4), but not depression symptoms (coefficient 0.2, 95%CI -0.0-0.3). CONCLUSIONS: Caregiver-detected patient delirium was associated with increased depression and anxiety symptoms in family caregivers of critically ill patients. Further randomized research is required to confirm these associations.


Asunto(s)
Cuidadores , Delirio , Adulto , Ansiedad/diagnóstico , Trastornos de Ansiedad , Enfermedad Crítica , Estudios Transversales , Delirio/diagnóstico , Depresión/diagnóstico , Humanos
15.
Medicine (Baltimore) ; 100(15): e25290, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847627

RESUMEN

ABSTRACT: Health care employees are the front liners whom are directly involved in the management of COVID-19 at high risk of developing psychological distress and other mental health illness. We aim to assess the burden of depression during this pandemic on health care employees treating COVID-19 in Saudi Arabia. We also will shed the light on the best solutions of how to encounter depression.A cross-sectional, hospital-based survey conducted via a region-stratified, 2-stage cluster sample was conducted for 554 participants in >15 hospitals from April 29, 2020, to June 30, 2020. Depression is measured using the established PHQ9 score system. We grade PHQ9 depression scores as: normal, 0 to 4, mild, 5 to 9, significant (moderate or severe), 10 to 27. χ2/Fisher exact test was used; significant association between level of depression and survey characteristics were made. P value <0.05 was considered statistically significant.A total of 554 participants completed the survey. A total of 18.9% (n = 105) were aged <29 years, 51.2% (n = 284) were between 30 to 39 years and female represent 70% of all participants. Of all participants, 53.7% (n = 298) were nurses, and 38.6% (n = 214) were physicians; 68.5% (n = 380) worked in central area hospitals in Saudi Arabia. No significant (P = .432, 95% confidence interval [CI]) association was observed between sex and depression classifications. However, female had high proportion of significant depression 75.0% (n = 76) was observed as compared to male 24.8% (n = 25). Depression was significant in Saudis 61.4% (n = 62) (P < .001, 95% CI) and medical staff who encountered corona patients 51.5% (n = 52) (P < .002, 95% CI). Hospital preparedness associated with more freedom of depression symptoms 69.1% (n = 199/288) (P < .001, 95% CI).Frontline young health care workers especially physician in Saudi Arabia reported a high rate of depression symptoms. Countermeasures for health care workers represent a key component for the mental and physical well-being as part of public health measures during this pandemic. Attention to hospital preparedness and adequacy of personal protective equipment contributed to milder depression symptoms. Further studies need to be conducted on crisis management and depression.


Asunto(s)
Ansiedad , Depresión , Personal de Salud , Control de Infecciones , Estrés Laboral , Adulto , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/prevención & control , /psicología , Estudios Transversales , Depresión/diagnóstico , Depresión/etiología , Depresión/prevención & control , Femenino , Personal de Salud/clasificación , Personal de Salud/psicología , Médicos Hospitalarios/psicología , Médicos Hospitalarios/estadística & datos numéricos , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Control de Infecciones/normas , Masculino , Salud Mental/estadística & datos numéricos , Salud Laboral/normas , Estrés Laboral/prevención & control , Estrés Laboral/psicología , Equipo de Protección Personal/provisión & distribución , Arabia Saudita/epidemiología
16.
RMD Open ; 7(1)2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33827969

RESUMEN

AIM: To assess the impact of the COVID-19 pandemic on patients with rheumatic and musculoskeletal diseases (RMDs). METHODS: REUMAVID is a cross-sectional study using an online survey developed by an international multidisciplinary patient-led collaboration across seven European countries targeting unselected patients with RMDs. Healthcare access, daily activities, disease activity and function, well-being (WHO Five Well-Being Index (WHO-5)), health status, anxiety/depression (Hospital Anxiety and Depression Scale (HADS)) and access to information were evaluated. Data were collected in April-July 2020 (first phase). RESULTS: Data from the first phase included 1800 patients with 15 different RMDs (37.2% axial spondyloarthritis, 29.2% rheumatoid arthritis, 17.2% osteoarthritis and others). Mean age was 53, 80% female and 49% had undertaken university studies. During the beginning of the pandemic, 58.4% had their rheumatology appointment cancelled and 45.6% reported not having received any information relating to the possible impact of SARS-CoV-2 infection in their RMDs, with the main source being patient organisations (27.6%).Regarding habits, 24.6% increased smoking, 18.2% raised their alcohol consumption, and 45.6% were unable to continue exercising. Self-reported disease activity was high (5.3±2.7) and 75.6% reported elevated pain. Half the patients (49.0%) reported poor well-being (WHO-5) and 46.6% that their health had changed for the worse during lockdown. According to HADS, 57.3% were at risk of anxiety and 45.9% of depression. CONCLUSION: Throughout the first wave of the COVID-19 pandemic, patients with RMDs have experienced disruption in access to healthcare services, poor lifestyle habits and negative effects on their overall health, well-being and mental health. Furthermore, information on COVID-19 has not reached patients appropriately.


Asunto(s)
Ansiedad , Depresión , Ejercicio Físico , Salud Mental/estadística & datos numéricos , Enfermedades Musculoesqueléticas , Aceptación de la Atención de Salud/estadística & datos numéricos , Enfermedades Reumáticas , Ansiedad/diagnóstico , Ansiedad/epidemiología , /psicología , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Europa (Continente)/epidemiología , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Enfermedades Musculoesqueléticas/diagnóstico , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Musculoesqueléticas/psicología , Gravedad del Paciente , Medición de Resultados Informados por el Paciente , Enfermedades Reumáticas/diagnóstico , Enfermedades Reumáticas/epidemiología , Enfermedades Reumáticas/psicología
17.
Harefuah ; 160(2): 76-80, 2021 Feb.
Artículo en Hebreo | MEDLINE | ID: mdl-33760407

RESUMEN

BACKGROUND: The Israeli National Program for Quality Measures determined the need for screening for depression during rehabilitation following stroke as a quality measure in the elderly; this is in order to better diagnose and treat post-stroke depression. The study's goal was to investigate whether adding screening for depression had an effect on the rate of diagnosis. Depression is a culture-dependent phenomenon, therefore the change in the rate of diagnosis of depression in the Arab population and the Jewish population was examined separately. METHODS: Data were collected from the computerized medical records of 879 patients (456 men; 423 women) admitted for rehabilitation following stroke between January 2015 and April 2019. In 2016, the quality measure was implemented. The PHQ-2 questionnaire was used for screening for depression. A comparison was made between the rate of patients diagnosed with depression before and after the introduction of the measure. RESULTS: No significant statistical difference was found in the diagnosis rate of post-stroke depression, before and after the quality measure of screening for depression was implemented. The results of the PHQ-2 questionnaire were found to be consistent with depression diagnosis. CONCLUSIONS: Screening for depression after stroke using the PHQ-2 questionnaire has not changed the diagnosis rate of depression in the Jewish or Arab elderly population. The quality measure performed during 2016-2019 had no additive value for the diagnosis of depression at the geriatric rehabilitation units at Shoham Geriatric Hospital. In recent years many quality measures have been added to the daily tasks in different units increasing the already heavy work load of the medical staff. This study emphasizes the importance of measuring the added value of quality measures, to enable proper use of resources and to decrease feelings of frustration and burnout among the medical staff.


Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Anciano , Árabes , Depresión/diagnóstico , Depresión/epidemiología , Depresión/etiología , Femenino , Humanos , Masculino , Tamizaje Masivo , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/epidemiología , Encuestas y Cuestionarios
18.
BMC Pregnancy Childbirth ; 21(1): 208, 2021 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-33722198

RESUMEN

BACKGROUND: Pregnancy is a risk factor for coronavirus disease 2019 (COVID-19). Pregnant women suffer from varying levels of pregnancy-related anxiety (PRA) which can negatively affect pregnancy outcomes. The aim of this study was to assess PRA and its associated factors during the COVID-19 pandemic. METHODS: This web-based cross-sectional study was conducted in 2020 on 318 pregnant women purposively recruited from primary healthcare centers in Sari and Amol, Iran. Data were collected using questionnaires (PRAQ, Edinburg, KAP of COVID-19, CDA-Q and Demographic questionnaire), which were provided to participants through the social media or were completed for them over telephone. Data were analyzed with the linear regression and the logistic regression analysis, at the significance level of 0.05 using the SPSS software (v. 21). RESULTS: Around 21% of participants had PRA, 42.1% had depression, and 4.4% had COVID-19 anxiety. The significant predictors of PRA were number of pregnancies (P = 0.008), practice regarding COVID-19 (P < 0.001), COVID-19 anxiety (P < 0.001), depression (P < 0.001), and social support (P = 0.025) which explained 19% of the total variance. Depression and COVID-19 anxiety increased the odds of PRA by respectively four times and 13%, while good practice regarding COVID-19 decreased the odds by 62%. CONCLUSION: Around 21% of pregnant women suffer from PRA during the COVID-19 pandemic and the significant predictors of PRA during the pandemic include number of pregnancies, practice regarding COVID-19, COVID-19 anxiety, depression, and social support. These findings can be used to develop appropriate strategies for the management of mental health problems during pregnancy in the COVID-19 pandemic.


Asunto(s)
Ansiedad , Complicaciones del Embarazo , Atención Primaria de Salud , Apoyo Social , Adulto , Ansiedad/diagnóstico , Ansiedad/epidemiología , Ansiedad/prevención & control , /prevención & control , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Femenino , Humanos , Irán/epidemiología , Evaluación de Necesidades , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/epidemiología , Complicaciones del Embarazo/prevención & control , Complicaciones del Embarazo/psicología , Mujeres Embarazadas/psicología , Atención Primaria de Salud/métodos , Atención Primaria de Salud/normas , Atención Primaria de Salud/tendencias , Factores de Riesgo , Estrés Psicológico/diagnóstico , Estrés Psicológico/epidemiología
19.
Medicine (Baltimore) ; 100(12): e25041, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761663

RESUMEN

BACKGROUND: Post-stroke depression (PSD) is one of the most common stroke complications with high morbidity. Researchers have done much clinical research on Traditional Chinese Medicine (TCM) treatment, but very little research on diagnosis. Based on the thought of combination of disease and syndrome, this study will establish a unified and objective quantitative diagnosis model of TCM syndromes of PSD, so as to improve the clinical diagnosis and treatment of PSD. OBJECTIVE: First: To establish a unified and objective quantitative diagnosis model of TCM syndromes in PSD under different disease courses, and identify the corresponding main, secondary, and concurrent symptoms, which are based on the weighting factor of each TCM symptom. Second: To find out the relationship between different stages of PSD and TCM syndromes. Clarify the main syndrome types of PSD under different stages of disease. Reveal the evolution and progression mechanism of TCM syndromes of PSD. METHODS AND ANALYSIS: This is a retrospective study of PSD TCM diagnosis. Three hundred patients who were hospitalized in the First Teaching Hospital of Tianjin University of TCM with complete cases from January 2014 to January 2019 are planned to be recruited. The study will mainly collect the diagnostic information from the cases, find the related indicators of TCM and Western medicine in PSD, and clarify the relationship between different disease stages and TCM syndromes. Finally, the PSD TCM syndrome quantitative diagnosis model will be established based on the operation principle of Back Propagation (BP) artificial neural network. CONCLUSION: To collect sufficient medical records and establish models to speed up the process of TCM diagnosis.


Asunto(s)
Depresión/diagnóstico , Medicina China Tradicional , Accidente Cerebrovascular/psicología , Adolescente , Adulto , Anciano , Depresión/terapia , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Síndrome , Adulto Joven
20.
BMC Geriatr ; 21(1): 180, 2021 03 12.
Artículo en Inglés | MEDLINE | ID: mdl-33711938

RESUMEN

BACKGROUND: Caregiver burden affects the caregiver's health and is related to the quality of care received by patients. This study aimed to determine the extent to which caregivers feel burdened when caring for patients with Alzheimer's Disease (AD) and to investigate the predictors for caregiving burden. METHODS: A cross-sectional study was conducted. One hundred two caregivers of patients with AD at Maharaj Nakorn Chiang Mai Hospital, a tertiary care hospital, were recruited. Assessment tools included the perceived stress scale (stress), PHQ-9 (depressive symptoms), Zarit Burden Interview-12 (burden), Clinical Dementia Rating (disease severity), Neuropsychiatric Inventory Questionnaires (neuropsychiatric symptoms), and Barthel Activities Daily Living Index (dependency). The mediation analysis model was used to determine any associations. RESULTS: A higher level of severity of neuropsychiatric symptoms (r = 0.37, p < 0.01), higher level of perceived stress (r = 0.57, p < 0.01), and higher level of depressive symptoms (r = 0.54, p < 0.01) were related to a higher level of caregiver burden. The direct effect of neuropsychiatric symptoms on caregiver burden was fully mediated by perceived stress and depressive symptoms (r = 0.13, p = 0.177), rendering an increase of 46% of variance in caregiver burden by this parallel mediation model. The significant indirect effect of neuropsychiatric symptoms by these two mediators was (r = 0.21, p = 0.001). CONCLUSION: Caregiver burden is associated with patients' neuropsychiatric symptoms indirectly through the caregiver's depressive symptoms and perception of stress. Early detection and provision of appropriate interventions and skills to manage stress and depression could be useful in reducing and preventing caregiver burden.


Asunto(s)
Enfermedad de Alzheimer , Depresión , Enfermedad de Alzheimer/diagnóstico , Cuidadores , Costo de Enfermedad , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Humanos , Escalas de Valoración Psiquiátrica
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