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1.
Psicol. conduct ; 25(1): 99-109, ene.-abr. 2020. mapas, tab, ilus
Artículo en Inglés | IBECS | ID: ibc-162156

RESUMEN

Youth social withdrawal has raised clinical concerns, and prevention of withdrawal behavior is important yet difficult. While human evaluation of withdrawal behavior can be subjective, technology provides objective measurement for withdrawal behavior. This study aims to examine the association between withdrawal behaviors (home-stay and non-communication) and mental health status (stress, depression and loneliness). The open-access StudentLife dataset, including the location and conversation information derived from the sensor data, stress levels, and pre- and post-questionnaires of depression (PHQ-9) and loneliness (RULS) of 47 college students over 10 weeks was used. Multilevel modeling and functional regression were employed for data analysis. Daily duration of home-stay was negatively associated with daily stress levels, and the interaction effect of daily duration of home-stay and non-communication were positively associated with daily stress levels and changes in PHQ-9 and RULS scores. Smartphone data is useful to provide adjunct information to the professional clinical judgement and early detection on withdrawal behavior


El aislamiento social de los jóvenes ha generado preocupaciones clínicas y prevenir estos comportamientos es importante pero difícil. Aunque la evaluación del aislamiento puede ser subjetiva, la tecnología proporciona medidas objetivas de este comportamiento. El objetivo de este estudio es examinar la asociación entre los comportamientos de aislamiento (permanecer en casa y no comunicarse) y el estado de la salud mental (estrés, depresión y soledad). Se utilizó la base de datos de libre acceso StudentLife, incluyendo información sobre la ubicación y la conversación registrada por un sensor de datos, los niveles de estrés y medidas de autoinforme pre y pos sobre depresión (PHQ-9) y soledad (RULS) de 47 estudiantes universitarios durante 10 semanas. Para el análisis de datos se utilizaron modelos multinivel y la regresión funcional. La duración diaria de la permanencia en casa estaba negativamente asociada con los niveles diarios de estrés y el efecto de interacción de la duración diaria de la permanencia en casa y la falta de comunicación estaban positivamente relacionados con los niveles diarios de estrés y los cambios en las puntuaciones en PHQ-9 y RULS. Los datos del teléfono inteligente son útiles para obtener información complementaria al juicio clínico profesional y para la detección temprana de los comportamientos de aislamiento


Asunto(s)
Humanos , Aislamiento Social/psicología , Soledad/psicología , Depresión/psicología , Psicometría/instrumentación , Estrés Psicológico/psicología , Diagnóstico Precoz , Medios de Comunicación Sociales , Factores de Riesgo , Tecnología de la Información , Comunicación
2.
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
3.
Prax Kinderpsychol Kinderpsychiatr ; 69(2): 126-140, 2020 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-32114950

RESUMEN

The Association Between Illicit Drug Use, Borderline Personality Disorder and Depression in a Help-Seeking Sample of Adolescents Risk-taking behavior is a common phenomenon in adolescence. Even prevalence rates for illicit drug use are considerably high in youth and associated with a range of psychiatric disorders, especially depression and Borderline Personality Disorder (BPD). However, there is a lack of data investigating differences in psychopathology between different substance user groups. Therefore, aim of the study was to investigate occurrence of depression and BPD symptoms in different drug risk groups (no use vs. occasional use vs. frequent use). Further aim of the study was to examine risk profiles regarding single BPD criteria. Data of n = 347 adolescents (81.7 % female, mean age 14.95, SD = 1.50) presenting at the specialized outpatient clinic for risk-taking and self-harming behavior (AtR!Sk) in Heidelberg were analyzed. Results show that BPD is clearly associated with illicit drug use in adolescence. There is no difference between occasional and frequent users in terms of mean number of BPD criteria. However, frequent users differ from occasional users regarding greater number of impulsivity and anger criteria. After adjusting for sociodemographic variables there was no association between drug use and depression. Since even single events of illicit drug use are associated with higher levels of BPD, clinicians should rapidly target to stop consumption. Further, psychotherapeutic interventions for BPD in high-risk consumers should especially focus on facilitating adaptive emotion regulation skills in regards to impulsivity and anger.


Asunto(s)
Trastorno de Personalidad Limítrofe/complicaciones , Trastorno de Personalidad Limítrofe/psicología , Depresión/complicaciones , Depresión/psicología , Conducta de Búsqueda de Ayuda , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/psicología , Adolescente , Trastorno Depresivo/complicaciones , Trastorno Depresivo/psicología , Femenino , Humanos , Masculino , Conducta Autodestructiva
4.
Am J Psychother ; 73(1): 8-14, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-32122161

RESUMEN

OBJECTIVE: Although the effectiveness of interpersonal psychotherapy (IPT) and cognitive therapy (CT) for major depression has been established, little is known about how and for whom they work and how they compare in the long term. The latter is especially relevant for IPT because research on its long-term effects has been limited. This overview paper summarizes findings from a Dutch randomized controlled trial on the effects and mechanisms of change of IPT versus CT for major depression. METHODS: Adult outpatients with depression (N=182) were randomly assigned to CT (N=76), IPT (N=75), or a 2-month waitlist control group followed by patient's treatment of choice (N=31). The primary outcome was depression severity. Other outcomes were quality of life, social and general psychological functioning, and scores on various mechanism measures. Interventions were compared at the end of treatment and up to 17 months follow-up. RESULTS: On average, IPT and CT were both superior to waitlist, and their outcomes did not differ significantly from one another. However, the pathway through which change occurred appeared to differ. For a majority of participants, one of the interventions was predicted to be more beneficial than the other. No support for the theoretical models of change was found. CONCLUSIONS: Outcomes of IPT and CT did not appear to differ significantly. IPT may have an enduring effect not different from that of CT. The field would benefit from further refinement of study methods to disentangle mechanisms of change and from advances in the field of personalized medicine (i.e., person-specific analyses and treatment selection methods).


Asunto(s)
Terapia Cognitivo-Conductual , Depresión/psicología , Depresión/terapia , Adulto , Femenino , Humanos , Masculino , Calidad de Vida , Resultado del Tratamiento
5.
Psychiatr Hung ; 35(2): 102-110, 2020.
Artículo en Húngaro | MEDLINE | ID: mdl-32191216

RESUMEN

Religious-spiritual crises include distress associated with the weakening or loss of faith, turbulent conversions, and affective states associated with negative spirituality. The differential diagnosis in regard to psychosis is often challenging. The purpose of the present study was to investigate the role of basic symptoms (changes in the subjective experience of perception, thinking, feeling, and self) in the differential diagnosis. We evaluated 106 help-seeking individuals with the Bonn Scale for the Assessment of Basic Symptoms (BSABS). The results indicated that religiousspiritual crises and psychotic states could be properly differentiated with the BSABS. Although the crisis and psychosis groups scored similarly on perplexity, self-disorder, depression, and anxiety, the disturbance of social contact and cognition was observed only in psychosis. These results indicate that the assessment of basic symptoms is useful in the differentiation of religious-spiritual crisis and psychosis, but it does not replace a multidisciplinary approach when, in addition to the routine psychiatric examination, the wider cultural context and the personal narratives are also considered.


Asunto(s)
Enfermedades Asintomáticas/psicología , Trastornos Psicóticos/psicología , Espiritualidad , Ansiedad/psicología , Depresión/psicología , Humanos
6.
Medicine (Baltimore) ; 99(8): e19325, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32080151

RESUMEN

Elucidation of epigenetic mechanisms correlating with neuropathic pain in humans is crucial for the prevention and treatment of this treatment-resistant pain state. In the present study, associations between neuropathic pain characteristics and DNA methylation of the transient receptor potential ankyrin 1 (TRPA1) gene were evaluated in chronic pain patients and preoperative patients. Pain and psychological states were prospectively assessed in patients who suffered chronic pain or were scheduled for thoracic surgery. Neuropathic characteristics were assessed using the Douleur Neuropathique 4 (DN4) questionnaire. DNA methylation levels of the CpG islands in the TRPA1 gene were examined using whole blood. Forty-eight adult patients were enrolled in this study. Increases in DNA methylation rates at CpG -51 showed positive correlations with increases in the DN4 score both in preoperative and chronic pain patients. Combined methylation rates at CpG -51 in these patients also significantly increased together with increase in DN4 scores. Neuropathic pain characteristics are likely associated with methylation rates at the promoter region of the TRPA1 gene in human peripheral blood.


Asunto(s)
Metilación de ADN , Neuralgia/genética , Canal Catiónico TRPA1/genética , Anciano , Dolor Crónico/genética , Islas de CpG , Depresión/psicología , Femenino , Humanos , Masculino , Neuralgia/psicología , Dimensión del Dolor , Regiones Promotoras Genéticas , Estudios Prospectivos
7.
Adv Exp Med Biol ; 1191: 187-196, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32002930

RESUMEN

Under the partial influences of paradigm shift form category to dimension, the Diagnostic and Statistical Manual of Mental Disorder (DSM) was revised to the fifth edition (DSM-5); however, due to the lack of consistent biological makers and processes and the restricted availability of dimensional meta-structure, the revisions for the DSM-5 were based on a combination of categorical and dimensional approaches. Anxiety disorders were more clearly and consistently defined in the DSM-5 with the removal of obsessive compulsive, acute stress, and post-traumatic stress disorders. Differences between the childhood and adulthood categories of anxiety disorders were decreased, and overall, the symmetrical classification of anxiety subtypes was increased, since separation anxiety disorder and selective mutism were considered anxiety disorders, not neurodevelopmental disorders. Additionally, based on growing evidence, agoraphobia is distinct from panic disorder. Next, considering cultural syndromes including taijin kyofusho, khyal cap, trung gio attacks, and ataque de nervios, cultural influences are considered a significant factor for definitions and presentations of anxiety disorders. Controversies in the DSM-5 criteria for anxiety disorders are lowering the diagnostic thresholds of anxiety disorders and limiting the dichotomous view of anxiety and depression when defining generalized anxiety disorder. Further studies of alternative approaches to the restrictions of the DSM-5 criteria of anxiety disorders, including transdiagnostic specifiers and dimensional assessment tools, may be required.


Asunto(s)
Trastornos de Ansiedad/clasificación , Trastornos de Ansiedad/diagnóstico , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Factores de Edad , Ansiedad/complicaciones , Ansiedad/psicología , Trastornos de Ansiedad/complicaciones , Trastornos de Ansiedad/psicología , Depresión/complicaciones , Depresión/psicología , Humanos , Trastornos por Estrés Postraumático/clasificación , Trastornos por Estrés Postraumático/diagnóstico
8.
Medicine (Baltimore) ; 99(3): e18633, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011443

RESUMEN

Pain has a major impact on anxiety and depression levels. The aim of this study is to demonstrate how these symptoms (depression and anxiety) could positively influence the perception of pain after neurostimulation system implantation.We enrolled 100 patients and divided in 2 different groups, by using tests screening such as Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), Nursing Rating Scale (NRS): the group with spinal cord stimulation (SCS) and the group with pulsed spinal cord radiofrequency (RFP).We highlighted a significant decrease of scores (BDI, HAM-A, NRS) in each group between T0 (baseline) and T1. Moreover, the intra-group analysis showed a positive significant correlation between NRS and depressive and anxiety symptoms.We assert that the use of alternative methods (SCS and RFP) to the traditional pharmaceutical-surgical treatments, provide the reduction of the algic and anxiety-depressant symptoms, restoring also the perception of psychological well-being.


Asunto(s)
Ansiedad/psicología , Dolor Crónico/psicología , Dolor Crónico/terapia , Depresión/psicología , Tratamiento de Radiofrecuencia Pulsada/psicología , Estimulación de la Médula Espinal/psicología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Escalas de Valoración Psiquiátrica , Tratamiento de Radiofrecuencia Pulsada/métodos , Estimulación de la Médula Espinal/métodos
11.
Am J Psychother ; 73(1): 15-21, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-32050784

RESUMEN

The digital age poses new challenges for psychotherapy. More than four billion people worldwide use the Internet, and most of them engage with social media. Therapists are increasingly asked to help patients navigate the complex interface between online technology and relationships, but few are prepared to address this issue therapeutically. Interpersonal psychotherapy (IPT) is an evidence-based psychotherapy for depression and is focused on addressing interpersonal problems. The authors use the IPT framework to explore how therapists can discuss, during in-person sessions, the impact of technology on communication and relationships. The authors describe how therapists can preserve IPT's overarching goal of resolving interpersonal problems by adapting specific techniques to meet the needs of patients who routinely rely on technology to connect with others. Case vignettes illustrate techniques used to evaluate and modify technology-based communication, including problematic text-based interactions. Recommendations are provided for therapists seeking to meet the interpersonal needs of patients in the digital age.


Asunto(s)
Depresión/terapia , Relaciones Interpersonales , Medios de Comunicación Sociales , Depresión/psicología , Humanos
12.
Am J Psychother ; 73(1): 22-28, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-32050785

RESUMEN

Family-based interpersonal psychotherapy (FB-IPT) is an evidence-based psychosocial intervention for depression in preadolescents (ages 8-12 years). Adapted from interpersonal psychotherapy for adolescents with depression and modified for younger children, this therapy includes structured dyadic sessions with preadolescents and their parents, guidance for parents in supporting their children and decreasing negative parent-child interactions, and a focus on preadolescents' comorbid anxiety and peer relationships. This article reviews the conceptual foundations and risk factors related to preadolescent depression and the rationale for focusing on improving preadolescents' interpersonal relationships to decrease depressive symptoms and risk for depression during adolescence. The structure and goals for the initial, middle, and termination phases of FB-IPT are described, as well as the specific communication and problem-solving strategies presented to preadolescents and parents. Last, research on the efficacy of FB-IPT is summarized, as are future directions for implementing this promising psychosocial intervention for preadolescent depression in community settings.


Asunto(s)
Depresión/terapia , Trastorno Depresivo/terapia , Terapia Familiar , Ansiedad/complicaciones , Niño , Depresión/complicaciones , Depresión/psicología , Trastorno Depresivo/complicaciones , Trastorno Depresivo/psicología , Humanos , Relaciones Interpersonales , Grupo Paritario
13.
Z Gerontol Geriatr ; 53(2): 112-118, 2020 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-32020285

RESUMEN

The prevalence of insomnia is particularly high in old age. Sleep disturbances and impaired daytime functioning reflected in mood swings and concentration difficulties are often accompanied by other mental disorders such as depression. The objective of this article is to shed light on the role of insomnia in the context of frequent comorbidities in middle and old age. The focus is on the identification of linkage points between insomnia and associated diseases on a neurobiological level; however, possible distinguishing features are also named and deliberations on cognitive behavioral aspects and integrative theories, such as the hyperarousal theory are discussed. In order to provide an outlook for future research opportunities, the UK Biobank is presented as a promising resource of long-term data. Finally, the contents of the preceding deliberations are critically reflected and practical implications for the treatment of older patients with insomnia are derived.


Asunto(s)
Encefalopatías/diagnóstico por imagen , Cognición/fisiología , Depresión/epidemiología , Neuroimagen/métodos , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Anciano , Anciano de 80 o más Años , Envejecimiento , Comorbilidad , Depresión/psicología , Trastorno Depresivo , Humanos , Persona de Mediana Edad , Prevalencia
15.
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
16.
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
17.
J Consult Clin Psychol ; 88(2): 149-159, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31894996

RESUMEN

BACKGROUND: The Acculturative Process and Context Framework (Ward & Geeraert, 2016) proposes that acculturative stressors influence psychological well-being over time. In fact, extant literature has linked bicultural stress with psychological functioning; yet, no studies have explored the causal dominance of bicultural stress. The purpose of the present study was to evaluate the directionality of prospective relations among bicultural stress and psychosocial functioning (i.e., depressive symptoms, hopefulness, and self-esteem) in Latinx immigrant adolescents across 5 waves. METHOD: There were 303 Latinx adolescents who were recruited for this study from Los Angeles and Miami and were assessed across 5 waves at 6-month intervals. Adolescents were 14.50 years old on average (SD = .88) and 53.16% were male. Adolescents reported living in the United States for 2.07 years on average (SD = 1.87). A Random-Intercept Cross-Lagged Panel Model (RI-CLPM) was used to examine the between- and within-person relations among bicultural stress, depressive symptoms, hopefulness, and self-esteem in a comprehensive model. RESULTS: The comprehensive RI-CLPM including bicultural stress, depressive symptoms, hopefulness, and self-esteem exhibited excellent model fit. Between-person, trait-like relations among constructs ranged from small to large, as expected. Within-person, cross-lagged estimates among constructs were overall inconsistent, with some evidence that, within individuals, self-esteem influences later hopefulness. CONCLUSION: Findings from this study indicate that the RI-CLPM is an effective strategy to examine bicultural stress and well-being processes among adolescents. There is a need for further research examining bicultural stress among Latinx immigrant youth, particularly within prevention and intervention studies. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Aculturación , Emigrantes e Inmigrantes/psicología , Salud Mental , Autoimagen , Estrés Psicológico/psicología , Adolescente , Conducta del Adolescente/psicología , Depresión/psicología , Femenino , Esperanza , Humanos , Masculino , Estados Unidos
19.
Epidemiol Psychiatr Sci ; 29: e96, 2020 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-31992379

RESUMEN

AIMS: Several studies suggested that depression might worsen the clinical outcome of diabetes mellitus; however, such association was confounded by duration of illness and baseline complications. This study aimed to assess whether depression increases the risk of diabetes complications and mortality among incident patients with diabetes. METHODS: This was a population-based matched cohort study using Taiwan's National Health Insurance Research Database. A total of 38 537 incident patients with diabetes who had depressive disorders and 154 148 incident diabetes patients without depression who were matched by age, sex and cohort entry year were randomly selected. The study endpoint was the development of macrovascular and microvascular complications, all-cause mortality and cause-specific mortality. RESULTS: Among participants, the mean (±SD) age was 52.61 (±12.45) years, and 39.63% were male. The average duration of follow-up for mortality was 5.5 years, ranging from 0 to 14 years. The adjusted hazard ratios were 1.35 (95% confidence interval [CI], 1.32-1.37) for macrovascular complications and 1.08 (95% CI, 1.04-1.12) for all-cause mortality. However, there was no association of depression with microvascular complications, mortality due to cardiovascular diseases or mortality due to diabetes mellitus. The effect of depression on diabetes complications and mortality was more prominent among young adults than among middle-aged and older adults. CONCLUSIONS: Depression was associated with macrovascular complications and all-cause mortality in our patient cohort. However, the magnitude of association was less than that in previous studies. Further research should focus on the benefits and risks of treatment for depression on diabetes outcome.


Asunto(s)
Depresión/complicaciones , Depresión/mortalidad , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/mortalidad , Adulto , Anciano , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/epidemiología , Estudios de Cohortes , Depresión/psicología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Factores de Riesgo , Taiwán/epidemiología
20.
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
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