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1.
Cochrane Database Syst Rev ; 1: CD003437, 2020 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-31989584

RESUMEN

BACKGROUND: Depression is an important morbidity associated with stroke that impacts on recovery yet often undetected or inadequately treated. This is an update and expansion of a Cochrane Review first published in 2004 and updated in 2008. OBJECTIVES: Primary objective • To determine whether pharmacological therapy, non-invasive brain stimulation, psychological therapy, or combinations of these interventions reduce the prevalence of diagnosable depression after stroke Secondary objectives • To determine whether pharmacological therapy, non-invasive brain stimulation, psychological therapy, or combinations of these interventions reduce levels of depressive symptoms, improve physical and neurological function and health-related quality of life, and reduce dependency after stroke • To assess the safety of and adherence to such treatments SEARCH METHODS: We searched the Specialised Registers of Cochrane Stroke and Cochrane Depression Anxiety and Neurosis (last searched August 2018), the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 1), in the Cochrane Library, MEDLINE (1966 to August 2018), Embase (1980 to August 2018), the Cumulative Index to Nursing and Alllied Health Literature (CINAHL) (1982 to August 2018), PsycINFO (1967 to August 2018), and Web of Science (2002 to August 2018). We also searched reference lists, clinical trial registers (World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) to August 2018; ClinicalTrials.gov to August 2018), and conference proceedings, and we contacted study authors. SELECTION CRITERIA: Randomised controlled trials comparing (1) pharmacological interventions with placebo; (2) one of various forms of non-invasive brain stimulation with sham stimulation or usual care; (3) one of various forms of psychological therapy with usual care and/or attention control; (4) pharmacological intervention and various forms of psychological therapy with pharmacological intervention and usual care and/or attention control; (5) non-invasive brain stimulation and pharmacological intervention with pharmacological intervention and sham stimulation or usual care; (6) pharmacological intervention and one of various forms of psychological therapy with placebo and psychological therapy; (7) pharmacological intervention and non-invasive brain stimulation with placebo plus non-invasive brain stimulation; (8) non-invasive brain stimulation and one of various forms of psychological therapy versus non-invasive brain stimulation plus usual care and/or attention control; and (9) non-invasive brain stimulation and one of various forms of psychological therapy versus sham brain stimulation or usual care plus psychological therapy, with the intention of treating depression after stroke. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed risk of bias, and extracted data from all included studies. We calculated mean difference (MD) or standardised mean difference (SMD) for continuous data, and risk ratio (RR) for dichotomous data, with 95% confidence intervals (CIs). We assessed heterogeneity using the I² statistic and certainty of the evidence according to GRADE. MAIN RESULTS: We included 49 trials (56 comparisons) with 3342 participants. Data were available for: (1) pharmacological interventions with placebo (with 20 pharmacological comparisons); (2) one of various forms of non-invasive brain stimulation with sham stimulation or usual care (with eight non-invasive brain stimulation comparisons); (3) one of various forms of psychological therapy with usual care and/or attention control (with 16 psychological therapy comparisons); (4) pharmacological intervention and various forms of psychological therapy with pharmacological intervention and usual care and/or attention control (with two comparisons); and (5) non-invasive brain stimulation and pharmacological intervention with pharmacological intervention and sham stimulation or usual care (with 10 comparisons). We found no trials for the following comparisons: (6) pharmacological intervention and various forms of psychological therapy interventions versus placebo and psychological therapy; (7) pharmacological intervention and non-invasive brain stimulation versus placebo plus non-invasive brain stimulation; (8) non-invasive brain stimulation and one of various forms of psychological therapy versus non-invasive brain stimulation plus usual care and/or attention control; and (9) non-invasive brain stimulation and one of various forms of psychological therapy versus sham brain stimulation or usual care plus psychological therapy. Treatment effects observed: very low-certainty evidence from eight trials suggests that pharmacological interventions decreased the number of people meeting study criteria for depression (RR 0.70, 95% CI 0.55 to 0.88; 1025 participants) at end of treatment, and very low-certainty evidence from six trials suggests that pharmacological interventions decreased the number of people with less than 50% reduction in depression scale scores at end of treatment (RR 0.47, 95% CI 0.32 to 0.69; 511 participants) compared to placebo. No trials of non-invasive brain stimulation reported on meeting study criteria for depression at end of treatment. Only one trial of non-invasive brain stimulation reported on the outcome <50% reduction in depression scale scores; thus, we were unable to perform a meta-analysis for this outcome. Very low-certainty evidence from six trials suggests that psychological therapy decreased the number of people meeting the study criteria for depression at end of treatment (RR 0.77, 95% CI 0.62 to 0.95; 521 participants) compared to usual care/attention control. No trials of combination therapies reported on the number of people meeting the study criteria for depression at end of treatment. Only one trial of combination (non-invasive brain stimulation and pharmacological intervention) therapy reported <50% reduction in depression scale scores at end of treatment. Thus, we were unable to perform a meta-analysis for this outcome. Five trials reported adverse events related to the central nervous system (CNS) and noted significant harm in the pharmacological interventions group (RR 1.55, 95% CI 1.12 to 2.15; 488 participants; very low-certainty evidence). Four trials found significant gastrointestinal adverse events in the pharmacological interventions group (RR 1.62, 95% CI 1.19 to 2.19; 473 participants; very low-certainty evidence) compared to the placebo group. No significant deaths or adverse events were found in the psychological therapy group compared to the usual care/attention control group. Non-invasive brain stimulation interventions and combination therapies resulted in no deaths. AUTHORS' CONCLUSIONS: Very low-certainty evidence suggests that pharmacological or psychological therapies can reduce the prevalence of depression. This very low-certainty evidence suggests that pharmacological therapy, psychological therapy, non-invasive brain stimulation, and combined interventions can reduce depressive symptoms. Pharmacological intervention was associated with adverse events related to the CNS and the gastrointestinal tract. More research is required before recommendations can be made about the routine use of such treatments.


Asunto(s)
Antidepresivos/uso terapéutico , Trastorno Depresivo/terapia , Terapia por Estimulación Eléctrica/métodos , Psicoterapia/métodos , Accidente Cerebrovascular/psicología , Trastorno Depresivo/etiología , Humanos , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto
2.
Braz J Psychiatry ; 42(3): 250-257, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31994636

RESUMEN

OBJECTIVE: To evaluate the interrelationships between childhood maltreatment, life satisfaction (LS), and depressive symptoms, and to investigate LS as a mediating factor in the association between childhood maltreatment and depressive symptoms. METHODS: The sample consisted of 342 adolescents, aged 11 to 17 years (mean = 13.3, SD = 1.52 years), recruited from a public school in Salvador, Brazil. Participants filled out instruments for the collection of sociodemographic data and evaluation of childhood maltreatment, LS, and depressive symptoms. Structural equation modeling (SEM) was used to evaluate the mediating effect of LS. RESULTS: We detected significant negative correlations between childhood maltreatment and LS and between LS and depressive symptoms. We observed a significant positive correlation between childhood maltreatment and depressive symptoms. LS partially mediated the association between childhood maltreatment and depressive symptoms, mitigating the impact of maltreatment. CONCLUSION: LS played an important mediating role in the association between childhood maltreatment and depressive symptoms. Longitudinal studies are recommended to fully elucidate these associations, reinforcing the need for attention and care of this vulnerable population.


Asunto(s)
Experiencias Adversas de la Infancia , Maltrato a los Niños/psicología , Trastorno Depresivo/psicología , Satisfacción Personal , Adolescente , Experiencias Adversas de la Infancia/estadística & datos numéricos , Brasil , Niño , Estudios Transversales , Trastorno Depresivo/etiología , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Encuestas y Cuestionarios
3.
Clin Exp Hypertens ; 42(2): 181-189, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-30957546

RESUMEN

Aim: We explored the role of histone modification in the association of depression-hypertension by comparing norepinephrine transporter (NET) gene levels in different depression-hypertensive patients. Then, we analyzed the expression of NET correlation with inflammatory cytokines to provide a new direction for detecting the association mechanism between depression and hypertension.Methods: NE expression levels in serum of diverse groups were detected by enzyme-linked immunosorbent assay. Then histone acetyltransferase (HAT), histone deacetylase (HDAC), H3K27ac, NET, TNF-α, and interleukin-6 (IL-6) were detected by western blot in nine female subjects in different depression and hypertension groups, and Chromatin immunoprecipitation-polymerase chain reaction (Chip-PCR) were used to confirm the degree of acetylation affecting on the transcription level of NET gene. Meanwhile, correlation between NET with TNF/IL-6 was analyzed by SPSS19.0 software program. Finally, Quantitative real-time polymerase chain reaction (qPCR) and western blot were used to detect TNF-α and IL-6 expression levels after NET overexpression or interference treatment in human umbilical vein endothelial cells and Neuro-2a cells.Results: The expression of HAT and H3K27ac had lower levels in D-H and nonD-H group than nonD-nonH group. The results showed that higher acetylation could promote expression of NET genes. Meanwhile, the expression of NET had a significant negative correlation with IL-6 (R = -0.933, p < 0.01) and tumor necrosis factor (TNF) (R = -0.817, p < 0.01) in subjects. In addition, the results confirmed that TNF-α and IL-6 mRNA and protein partial expressions could be inhibited by NET in both HUVECs and Neuronal cells (p < 0.01).Conclusion: In conclusion, differential expression of NET gene might function as an important factor in interaction between depression and hypertension by partially targeting TNF-α and IL-6.


Asunto(s)
Trastorno Depresivo/etiología , Hipertensión/etiología , Interleucina-6/metabolismo , Proteínas de Transporte de Noradrenalina a través de la Membrana Plasmática/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Acetilación , Citocinas/metabolismo , Femenino , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Humanos
4.
Disabil Health J ; 13(1): 100821, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31422169

RESUMEN

BACKGROUND: Caregivers are essential for assisting people with disabilities to fully participate in their communities. Past research has primarily focused on family caregivers in the U.S. providing care to older adults rather than children and adults with disabilities. OBJECTIVE: This paper examines the demographic and health characteristics of caregivers of children and adults with disabilities across the lifespan using data from the 2017 Health Information National Trends Survey (HINTS). METHODS: Chi square, t-test, linear and logistic regression analyses show differences between caregivers and non-caregivers related to gender, age, employment, and specific health outcomes. RESULTS: Of 3285 respondents, 18% self-identified as caregivers of children or adults with disabilities (n = 546). Almost one-third of all caregivers reported being diagnosed with depression or an anxiety disorder as compared to one-fifth of non-caregivers. Psychological distress was associated with an increased risk for a diagnosis of depression/anxiety. We also found that distress decreased with age when controlling for other factors. CONCLUSION: This paper increases knowledge of a growing segment of family caregivers providing care for members with disabilities across the lifespan. Research and policy needs are discussed.


Asunto(s)
Trastornos de Ansiedad/epidemiología , Ansiedad/epidemiología , Cuidadores/psicología , Depresión/epidemiología , Personas con Discapacidad , Estado de Salud , Estrés Psicológico , Adolescente , Adulto , Factores de Edad , Anciano , Ansiedad/etiología , Trastornos de Ansiedad/etiología , Niño , Preescolar , Depresión/etiología , Trastorno Depresivo/epidemiología , Trastorno Depresivo/etiología , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Estrés Psicológico/complicaciones , Estados Unidos , Adulto Joven
5.
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 , Distrés Psicológico , Psicometría/normas , Reproducibilidad de los Resultados , Apoyo Social
6.
Support Care Cancer ; 28(1): 211-220, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31001695

RESUMEN

PURPOSE: Our study provides data on depression and anxiety in long-term cancer survivors, in men, women and various age groups, as well as identifies associated factors and coping-related resources. METHODS: We present data obtained from 1002 cancer survivors across a large variety of tumour entities 5 years (cohort 1) and 10 years (cohort 2) after diagnosis, in a cross-sectional study. We analysed depression (PHQ-9) and anxiety (GAD-7) symptomatology in comparison with two large age- and sex-matched samples randomly selected from the general population. RESULTS: Moderate to severe depression and anxiety were reported in 17% and 9% of cancer survivors, respectively. There were no significant differences between the 5 years and 10 years after diagnosis cohorts (p = 0.232). In both cohorts, we found higher depression and anxiety in women than in men (p < 0.001), and lower depression and anxiety in elderly patients (p < 0.001). Cancer survivors younger than 60 years of age were more depressed and anxious than the general population (p < 0.001). The variables, financial problems (Beta = 0.16, p < 0.001), global quality of life (Beta = - 0.21, p < 0.001) and cognitive function (Beta = - 0.30, p < 0.001), had the strongest association with depression and anxiety. CONCLUSIONS: For the prevention of depression and anxiety in long-term cancer survivors, individual treatment of physical and psychological symptoms is as important as social support and professional counselling. Post-treatment, cognitive limitations should be carefully assessed in long-term cancer survivorship to distinguish them from symptoms of a mental disorder, especially since younger cancer survivors of working age and female survivors seem to be more affected by depression and anxiety.


Asunto(s)
Ansiedad/epidemiología , Supervivientes de Cáncer/estadística & datos numéricos , Depresión/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ansiedad/etiología , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/etiología , Supervivientes de Cáncer/psicología , Estudios de Casos y Controles , Estudios de Cohortes , Estudios Transversales , Depresión/etiología , Trastorno Depresivo/epidemiología , Trastorno Depresivo/etiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico , Neoplasias/epidemiología , Neoplasias/psicología , Calidad de Vida/psicología , Apoyo Social , Adulto Joven
7.
J Child Adolesc Ment Health ; 31(3): 214-223, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31805836

RESUMEN

Background: There is limited data on the prevalence of child and adolescent mental health disorders (CAMHD) in Ghana. Recent reports suggest a decline in academic achievement in basic education. This paper sought to determine the prevalence of CAMHD in Ghanaian primary school children and to draw correlates with academic achievement.Methods: We conducted a pilot cross-sectional survey of 303 grade 3 pupils aged 7-15 years in the city of Kumasi. The Child Behaviour Checklist (CBCL) and Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) were used to assess for CAMHD in 2016, and data on performance in examinations over the prior academic year were analysed.Results: Overall, current prevalence of CAMHD was 7.25%, with depressive disorder = 1.31%, anxiety disorders = 1%, attention deficit hyperactivity disorder (ADHD) = 1.64%, conduct disorder = 1.97%, and intellectual disability = 1%. Co-morbid disorders, such as seizure disorder (1%), were also noted. There was a greater prevalence of CAMHD in public schools (11.6%) compared to private schools (0.7%), with p < 0.001. Even when adjusted for other factors, children with CAMHD had a lower average academic score by 10.5 units (p < 0.001). Thus, having a dual diagnosis was most predictive of academic underachievement.Conclusions: The results of this study document the prevalence of CAMHD in Ghana for the first time and shows correlates with academic underachievement.


Asunto(s)
Escolaridad , Trastornos Mentales/epidemiología , Adolescente , Factores de Edad , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/etiología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/etiología , Niño , Trastorno de la Conducta/epidemiología , Trastorno de la Conducta/etiología , Estudios Transversales , Trastorno Depresivo/epidemiología , Trastorno Depresivo/etiología , Femenino , Ghana/epidemiología , Humanos , Discapacidad Intelectual/epidemiología , Discapacidad Intelectual/etiología , Masculino , Trastornos Mentales/etiología , Prevalencia , Convulsiones/epidemiología , Convulsiones/etiología
8.
An Bras Dermatol ; 94(6): 704-709, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31789266

RESUMEN

BACKGROUND: Rosacea may result in emotional distress and anxiety. However, data on the presence of generalized anxiety disorder in rosacea patients are scarce. OBJECTIVE: The aim of the study was to detect the frequency and level of anxiety and depression in patients with rosacea. METHODS: A total of 194 consecutive rosacea patients and 194 age- and sex-matched controls were enrolled. Severity of rosacea was assessed in patients according to the criteria of the National Rosacea Society Ethics Committee. Both patients and controls were evaluated by the Generalized Anxiety Disorder 7-item scale, and severity was measured by the Generalized Anxiety Disorder-Adult. RESULTS: Individuals who were diagnosed with an anxiety and/or depressive disorder were more common in patient group (24.7% vs. 7.2%, p<0,01). Female patients were particularly at risk for having generalized anxiety disorder (OR=2.8; 95% CI 1.15-7.37; p=0.02). STUDY LIMITATIONS: Single center study and limited sample size. CONCLUSIONS: Rosacea patients show greater risk of having anxiety disorders, including generalized anxiety disorder. Female patients, those with lower educational levels, those with phymatous subtype, untreated patients, and patients with prior psychiatric morbidity may be at particular risk for anxiety. It is essential to consider the psychological characteristics of patients to improve their well-being.


Asunto(s)
Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/etiología , Trastorno Depresivo/epidemiología , Trastorno Depresivo/etiología , Rosácea/complicaciones , Rosácea/epidemiología , Adulto , Análisis de Varianza , Estudios de Casos y Controles , Estudios Transversales , Escolaridad , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prevalencia , Escalas de Valoración Psiquiátrica , Calidad de Vida , Factores de Riesgo , Rosácea/psicología , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , Encuestas y Cuestionarios
9.
Presse Med ; 48(12): 1507-1519, 2019 Dec.
Artículo en Francés | MEDLINE | ID: mdl-31767248

RESUMEN

Vagus nerve stimulation (VNS) is an old, yet new, option for treatment-resistant depression. Despite several clinical trials over the last 15 years showing a consistent benefit-risk balance of the technic, VNS still struggles to find its place in our therapeutic algorithms. This is especially true in France, where only a few surgeries have been performed nationwide, all in the last year. The reasons behind this lag are manifolds; (1) psychiatrists usually do not consider surgical treatments, even when they are minimally invasive and reversible, (2) early VNS trials stumbled on methodological difficulties that are common to all invasive neurostimulation technics, and initially failed to provide strong evidence for its efficacy, and (3) VNS requires multidisciplinary teams involving psychiatrists and neurosurgeons that did not exist then. Nevertheless, studies of the past twenty years support VNS as a treatment of depression endowed with a unique efficacy profile: a long runner best at maintaining remission in hard-to-stabilize depression, even in the context of ECT withdrawal, and irrespective of whether it is unipolar or bipolar. Thus, VNS potentially addresses the unmet medical needs of some of the most severe and chronic patients with depression. This review aims at introducing VNS as a treatment option for depression, summarizing available evidence for its efficacy and tolerance, and delineating patient profiles that might benefit the most of such treatment.


Asunto(s)
Depresión/terapia , Estimulación del Nervio Vago , Depresión/epidemiología , Depresión/etiología , Trastorno Depresivo/epidemiología , Trastorno Depresivo/etiología , Trastorno Depresivo/terapia , Francia/epidemiología , Humanos , Resultado del Tratamiento , Nervio Vago/fisiología , Estimulación del Nervio Vago/efectos adversos , Estimulación del Nervio Vago/métodos , Estimulación del Nervio Vago/tendencias
10.
Int J Mol Sci ; 20(23)2019 Nov 24.
Artículo en Inglés | MEDLINE | ID: mdl-31771312

RESUMEN

TWIK-related potassium channel-1 (TREK-1) is broadly expressed in the brain and involved in diverse brain diseases, such as seizures, ischemia, and depression. However, the cell type-specific roles of TREK-1 in the brain are largely unknown. Here, we generated a Cre-dependent TREK-1 knockdown (Cd-TREK-1 KD) transgenic mouse containing a gene cassette for Cre-dependent TREK-1 short hairpin ribonucleic acid to regulate the cell type-specific TREK-1 expression. We confirmed the knockdown of TREK-1 by injecting adeno-associated virus (AAV) expressing Cre into the hippocampus of the mice. To study the role of hippocampal neuronal TREK-1 in a lipopolysaccharide (LPS)-induced depression model, we injected AAV-hSyn-BFP (nCTL group) or AAV-hSyn-BFP-Cre (nCre group) virus into the hippocampus of Cd-TREK-1 KD mice. Interestingly, the immobility in the tail suspension test after LPS treatment did not change in the nCre group. Additionally, some neurotrophic factors (BDNF, VEGF, and IGF-1) significantly increased more in the nCre group compared to the nCTL group after LPS treatment, but there was no difference in the expression of their receptors. Therefore, our data suggest that TREK-1 in the hippocampal neurons has antidepressant effects, and that Cd-TREK-1 KD mice are a valuable tool to reveal the cell type-specific roles of TREK-1 in the brain.


Asunto(s)
Trastorno Depresivo/etiología , Hipocampo/metabolismo , Canales de Potasio de Dominio Poro en Tándem/genética , Animales , Conducta Animal/efectos de los fármacos , Corticosterona/sangre , Citocinas/genética , Citocinas/metabolismo , Giro Dentado/metabolismo , Dependovirus/genética , Trastorno Depresivo/metabolismo , Modelos Animales de Enfermedad , Vectores Genéticos/genética , Vectores Genéticos/metabolismo , Lipopolisacáridos/toxicidad , Ratones , Ratones Transgénicos , ARN Interferente Pequeño/genética , ARN Interferente Pequeño/metabolismo
11.
Curr Cardiol Rep ; 21(11): 145, 2019 11 22.
Artículo en Inglés | MEDLINE | ID: mdl-31758344

RESUMEN

PURPOSE OF REVIEW: Adults with congenital heart disease face many potential psychosocial challenges. This review focuses on their experiences of clinically significant anxiety and depression and provides recommendations for appropriately timed referrals to mental health professionals. RECENT FINDINGS: Adults with congenital heart disease have a higher probability of experiencing symptoms consistent with mood and anxiety disorders, yet risk factors are not well understood. Although patients as a group are often interested in psychological treatment, there is currently under-recognition and under-treatment of mental health concerns. As provider and patient awareness of the biopsychosocial implications of living with congenital heart disease continues to grow, the focus of comprehensive care is broadening to include attention to psychosocial well-being. Care teams are encouraged to create a culture that fosters open and ongoing dialog about emotional well-being, including depression and anxiety, and includes reliable processes for mental health referrals.


Asunto(s)
Trastornos de Ansiedad/etiología , Trastorno Depresivo/etiología , Cardiopatías Congénitas/psicología , Adulto , Ansiedad/etiología , Ansiedad/terapia , Trastornos de Ansiedad/terapia , Depresión/etiología , Depresión/terapia , Trastorno Depresivo/terapia , Cardiopatías Congénitas/complicaciones , Humanos , Prevalencia , Derivación y Consulta , Factores de Riesgo , Estrés Psicológico
12.
Dev Cogn Neurosci ; 40: 100707, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31733523

RESUMEN

Adolescence is a neuroplastic period for self-processing and emotion regulation transformations, that if derailed, are linked to persistent depression. Neural mechanisms of adolescent self-processing and emotion regulation ought to be targeted via new treatments, given moderate effectiveness of current interventions. Thus, we implemented a novel neurofeedback protocol in adolescents to test the engagement of circuits sub-serving self-processing and emotion regulation. METHODS: Depressed (n = 34) and healthy (n = 19) adolescents underwent neurofeedback training using a novel task. They saw their happy face as a cue to recall positive memories and increased displayed amygdala and hippocampus activity. The control condition was counting-backwards while viewing another happy face. A self vs. other face recognition task was administered before and after neurofeedback training. RESULTS: Adolescents showed higher frontotemporal activity during neurofeedback and higher amygdala and hippocampus and hippocampi activity in time series and region of interest analyses respectively. Before neurofeedback there was higher saliency network engagement for self-face recognition, but that network engagement was lower after neurofeedback. Depressed youth exhibited higher fusiform, inferior parietal lobule and cuneus activity during neurofeedback, but controls appeared to increase amygdala and hippocampus activity faster compared to depressed adolescents. CONCLUSIONS: Neurofeedback recruited frontotemporal cortices that support social cognition and emotion regulation. Amygdala and hippocampus engagement via neurofeedback appears to change limbic-frontotemporal networks during self-face recognition. A placebo group or condition and contrasting amygdala and hippocampus, hippocampi or right amygdala versus frontal loci of neurofeedback, e.g. dorsal anterior cingulate cortex, with longer duration of neurofeedback training will elucidate dosage and loci of neurofeedback in adolescents.


Asunto(s)
Mapeo Encefálico/métodos , Trastorno Depresivo/etiología , Imagen por Resonancia Magnética/métodos , Neurorretroalimentación/métodos , Plasticidad Neuronal/genética , Adolescente , Femenino , Humanos , Masculino
13.
BMC Public Health ; 19(1): 1524, 2019 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-31727052

RESUMEN

BACKGROUND: The use of computers/TV has become increasingly common worldwide after entering the twenty-first century and depression represents a growing public health burden. Understanding the association between screen time-based sedentary behavior (ST-SB) and the risk of depression is important to the development of prevention and intervention strategies. METHODS: We searched the electronic databases of Medline, Embase and the Cochrane Library. The odds ratio (OR) with corresponding 95% confidence intervals (CIs) was adopted as the pooled measurement. Subgroup analyses were investigated by stratified meta-analyses based on age, gender and reference group (reference category of screen time, e.g. 2 h/day, 4 h/day). RESULTS: There were 12 cross-sectional studies and 7 longitudinal studies met the inclusion criteria. Overall, the pooled OR was 1.28 with high heterogeneity (I2 = 89%). Compared to those who reported less SB, persons reporting more SB had a significantly higher risk of depression. When the gender was stratified, the pooled OR was 1.18 in female groups while no significant association was observed in males. Among the 19 studies, 5 studies used a reference group with ST = 2 h/days (pooled OR = 1.46), 9 studies used ≥4 h as a reference group (pooled OR = 1.38), 2 studies used 1 h as a reference group (pooled OR = 1.07) and for the remaining 3 studies, hours of ST were calculated as a continuous variable (pooled OR = 1.04). CONCLUSIONS: ST-SB is associated with depression risk and the effects vary in different populations. In addition, valid objective measures of SB should be developed in future studies.


Asunto(s)
Computadores , Depresión/etiología , Trastorno Depresivo/etiología , Ejercicio Físico/psicología , Tiempo de Pantalla , Conducta Sedentaria , Televisión , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Adulto Joven
14.
Trends Psychiatry Psychother ; 41(3): 227-236, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31644691

RESUMEN

OBJECTIVE: An important subject in evaluation of the efficacy of treatments is to examine how the intervention is effective and to identify the consequences of that treatment. In this regard, the current study investigates the role of emotion regulation as the mediator of the treatment outcomes of therapy using the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders. METHOD: This article describes a double-blind randomized clinical trial. A sample of 26 individuals was selected based on cut-off scores for the Beck Depression Inventory and Beck Anxiety Inventory and their final diagnoses were confirmed with the Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV). The sample was randomly divided into two groups: control and treatment (13 patients each). The treatment group received 20 one-hour UP sessions. The Beck Depression Inventory, the Beck Anxiety Inventory, and the Difficulties in Emotion Regulation Scale were administered at two stages, pre-treatment and post-treatment. RESULTS: The UP reduced anxiety and depression in patients through improvement in emotion regulation. Furthermore, the results showed that the difficulty engaging in goal-directed behavior and non-acceptance of emotional response subscales were capable of predicting 62% of variance in anxiety scores. In turn, two subscales, difficulty engaging in goal-directed behavior and lack of emotional clarity, predicted 72% of variance in depression scores. CONCLUSION: Emotion regulation can be considered as a potential mediating factor and as predictive of outcomes of transdiagnostic treatment based on the UP. CLINICAL TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT2017072335245N1.


Asunto(s)
Síntomas Afectivos/terapia , Trastornos de Ansiedad/prevención & control , Trastorno Depresivo/prevención & control , Regulación Emocional/fisiología , Adulto , Síntomas Afectivos/psicología , Trastornos de Ansiedad/etiología , Protocolos Clínicos , Trastorno Depresivo/etiología , Método Doble Ciego , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Resultado del Tratamiento
15.
Int J Med Sci ; 16(9): 1260-1270, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31588192

RESUMEN

Background: Accumulating evidence has shown that neuropsychiatric disorders are associated with gut microbiota through the gut-brain axis. However, the effects of antidepressant treatment on gut microbiota are rarely studied. Here, we investigated whether stress led to gut microbiota changes and whether fluoxetine plays a role in microbiota alteration. Methods: We investigated changes in gut microbiota in a depression model induced by chronic unpredicted mild stress (CUMS) and a restoration model by applying the classic antidepressant drug fluoxetine. Results: We found that stress led to low bacterial diversity, simpler bacterial network, and increased abundance of pathogens, such as Escherichia/Shigella, and conditional pathogens, such as Enterococcus, Vagococcus, and Aerococcus. However, these changes were attenuated by fluoxetine directly and indirectly. Furthermore, the correlation analysis indicated strong correlations between gut microbiota and anxiety- and depression-like behaviors. Conclusions: This study revealed that fluoxetine led to restoration of dysbiosis induced by stress stimulation, which may imply a possible pathway through which one CNS target drug plays its role in reshaping the gut microbiota.


Asunto(s)
Antidepresivos de Segunda Generación/farmacología , Trastorno Depresivo/tratamiento farmacológico , Disbiosis/tratamiento farmacológico , Fluoxetina/farmacología , Estrés Psicológico/complicaciones , Animales , Ansiedad/tratamiento farmacológico , Trastorno Depresivo/etiología , Trastorno Depresivo/microbiología , Modelos Animales de Enfermedad , Disbiosis/microbiología , Microbioma Gastrointestinal/efectos de los fármacos , Masculino , Ratones Endogámicos C57BL
16.
Int J Mol Sci ; 20(19)2019 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-31569393

RESUMEN

Depression has become one of the most severe psychiatric disorders and endangers the health of living beings all over the world. In order to explore the molecular mechanism that underlies depression, different kinds of animal models of depression are used in laboratory experiments. However, a credible and reasonable animal model that is capable of imitating the pathologic mechanism of depression in mankind has yet to be found, resulting in a barrier to further investigation of depression. Nevertheless, it is possible to explain the pathologic mechanism of depression to a great extent by a rational modeling method and behavioral testing. This review aims to provide a reference for researchers by comparing the advantages and disadvantages of some common animal depression models.


Asunto(s)
Depresión/psicología , Trastorno Depresivo/psicología , Animales , Conducta Animal , Depresión/etiología , Trastorno Depresivo/etiología , Modelos Animales de Enfermedad , Humanos
17.
J Neurol ; 266(12): 3119-3125, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31535268

RESUMEN

OBJECTIVE: Improvement of quality-of-life (QoL) has been termed as a primary objective in initiating therapy in both Parkinson's disease (PD) and multiple system atrophy Parkinsonian subtype (MSA-P). We aimed to compare the determinants of life quality in drug naïve PD and MSA-P patients. METHODS: Eighty-six drug-naïve PD patients and thirty-five drug-naïve MSA-P patients were included to explore the determinants of QoL. Demographic information, motor deficits, and non-motor symptoms were included in the clinical assessment. RESULTS: Both motor and non-motor functions were more severely impaired in the drug-naïve MSA-P patients, with higher PDQ-39 scores indicating poorer QoL. Physical discomfort and stigma were the main affected sub-domains in PD, while mobility and activity of daily life were the main affected ones in MSA-P. BECK depressive scores and UPDRS-III scores were independent variables of PDQ-39 in MSA-P patients. Age, depression, disease stages and non-motor scores were independent variables of PDQ-39 in PD patients. INTERPRETATION: Drug-naïve MSA-P patients suffered from more severe motor and non-motor disability, as well as poorer QoL. Depression and non-motor symptoms were proved to be the most critical determinants for QoL in PD, while motor function was supposed to be the major determinant for MSA-P. When initiating therapy, physicians need to focus more on motor functions in drug-naïve MSA-P patients, but on depression in PD patients.


Asunto(s)
Trastorno Depresivo/fisiopatología , Discinesias/fisiopatología , Atrofia de Múltiples Sistemas/fisiopatología , Trastornos Parkinsonianos/fisiopatología , Calidad de Vida , Anciano , Trastorno Depresivo/etiología , Quimioterapia/normas , Discinesias/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Atrofia de Múltiples Sistemas/complicaciones , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/fisiopatología , Trastornos Parkinsonianos/complicaciones
18.
Artículo en Inglés | MEDLINE | ID: mdl-31557823

RESUMEN

This study examines the relationship between volatile income and depression, and moderating effects of living arrangements among older adults in South Korea. Using the Korean Longitudinal Study of Aging, we studied 4123 adults aged 60 or older. Income volatility was defined as the variance of logged income across four assessments from 2006 to 2012. Depression was measured as the Center for Epidemiologic Studies Depression (CES-D) scores in 2012. It was examined whether income volatility was related to depressive symptoms, and whether the association depended on co-residence with children. In results, income volatility was not related to CES-D scores in main-effect models without an interaction term. The relationship between income volatility and depressive symptoms depended on co-residence with children (p < 0.001). Higher income volatility was linked to increased risks of CES-D scores among the elderly living without children (incident rate ratio (IRR): 1.27, 95% confidence interval (CI): 1.07-1.50, p-value: 0.005) whereas it was related to lower CES-D scores among those co-residing with children (IRR: 0.68, 95% CI: 0.52-0.88, p-value: 0.003). Absolute income volatility has detrimental psychological consequences for older adults who live on their own. The finding implies that social protection policies for elderly households that live with an unstable income are needed.


Asunto(s)
Depresión/etiología , Trastorno Depresivo/etiología , Composición Familiar , Renta , Anciano , Anciano de 80 o más Años , Depresión/epidemiología , Trastorno Depresivo/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , República de Corea/epidemiología , Características de la Residencia
19.
Artículo en Inglés | MEDLINE | ID: mdl-31557844

RESUMEN

This study aimed to compare the mean scores of mobile phone use, mobile phone addiction, and depressive symptoms at three-time points among Korean adolescents according to gender and to examine the differences in the long-term relationships among the three abovementioned variables between Korean boys and girls in a four-year period. Data for 1794 adolescents (897 boys and 897 girls) were obtained from three waves of the second panel of the Korean Children and Youth Panel Survey. Multigroup structural equation modeling was used for data analyses. The study findings showed that at each of the three-time points, Korean girls tended to use their mobile phones more frequently and were at a higher risk of mobile phone addiction and depressive symptoms than Korean boys. Significant changes were observed in the longitudinal relationships among phone use, mobile phone addiction, and depressive symptoms in Korean adolescents across time periods, but no gender differences were found in the strengths of these relationships. These findings contribute to expanding the knowledge base of mobile phone addiction and depressive symptoms among Korean adolescents.


Asunto(s)
Conducta Adictiva/epidemiología , Uso del Teléfono Celular/estadística & datos numéricos , Depresión/epidemiología , Trastorno Depresivo/epidemiología , Adolescente , Conducta Adictiva/etiología , Teléfono Celular/estadística & datos numéricos , Uso del Teléfono Celular/efectos adversos , Depresión/etiología , Trastorno Depresivo/etiología , Femenino , Humanos , Masculino , República de Corea/epidemiología , Factores Sexuales , Encuestas y Cuestionarios
20.
Braz J Med Biol Res ; 52(9): e8533, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31483000

RESUMEN

This study aimed to evaluate the effect of a newly designed intensive caregiver education program (ICEP) on reducing cognitive impairment, anxiety, and depression in acute ischemic stroke (AIS) patients. One hundred and ninety-six AIS patients were divided into ICEP group and Control group in a 1:1 ratio using blocked randomization method. In the ICEP group, the caregivers received ICEP, while in the Control group caregivers received usual education and guidance. All patients received conventional rehabilitation treatment. Cognitive impairment (assessed by Mini Mental State Examination (MMSE) score and Montreal Cognitive Assessment (MoCA) score), anxiety (assessed by Hospital Anxiety and Depression Scale (HADS)-A score and Self-rating Anxiety Scale (SAS) score), and depression (assessed by HADS-D score and Self-rating Depression Scale (SDS) score) were assessed at baseline (M0), 3 months (M3), 6 months (M6), and 12 months (M12). Cognitive impairment score at M12 and cognitive impairment score change (M12-M0) were increased, while cognitive impairment rate at M12 was reduced in the ICEP group compared with the Control group. Anxiety score change (M12-M0), anxiety score at M12, and anxiety rate at M12 were decreased in the ICEP group compared with the Control group. Depression score change (M12-M0), depression score at M12, and depression rate at M12 were lower in the ICEP group compared with the Control group. Further subgroup analysis based on baseline features also provided similar results. In conclusion, ICEP effectively reduced cognitive impairment, anxiety, and depression in AIS patients.


Asunto(s)
Trastornos de Ansiedad/prevención & control , Ansiedad/prevención & control , Cuidadores , Disfunción Cognitiva/prevención & control , Trastorno Depresivo/prevención & control , Educación en Salud/métodos , Accidente Cerebrovascular/enfermería , Adulto , Ansiedad/etiología , Trastornos de Ansiedad/etiología , Estudios de Casos y Controles , Disfunción Cognitiva/etiología , Trastorno Depresivo/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/psicología , Rehabilitación de Accidente Cerebrovascular
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