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1.
Saudi Med J ; 42(10): 1117-1124, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34611007

RESUMEN

OBJECTIVES: To investigate the degree of public awareness, beliefs, and attitudes regarding major depression and available treatment options in the Saudi population. METHODS: A community-based cross-sectional study of 1,188 participants was carried out from March to April 2021 in Ha'il, Saudi Arabia using an online self-administered questionnaire. Using a snowball sampling technique, the authors targeted the Saudi population living in Ha'il region. RESULTS: Overall, 65.6% of the participants had good awareness regarding depression disorder in total. Of the participants, 72.9% had good awareness regarding general awareness, 85.4% regarding depression symptoms, 12.3% regarding risk factors, and 15.7% regarding treatments. Of the participants, 67.3% believed that depression was caused by lack of faith and 45.5% believed that depression was caused by "the evil eye" or black magic. Of the participants, 56% believed in faith healers as a legitimate treatment approach. Of the participants, 63.9% were willing to work with individuals with depression, 62.7% were willing to establish friendships with them, and 27.9% believed that individuals with depression had weak personalities. CONCLUSION: The general population exhibited good general awareness regarding depression and its symptoms, but knowledge of risk factors and treatments was poor. Our findings underscore the need for public educational programs to increase public awareness about the risk factors and treatment options for depression.


Asunto(s)
Trastorno Depresivo , Conocimientos, Actitudes y Práctica en Salud , Estudios Transversales , Trastorno Depresivo/epidemiología , Trastorno Depresivo/terapia , Humanos , Arabia Saudita/epidemiología , Encuestas y Cuestionarios
2.
Artículo en Ruso | MEDLINE | ID: mdl-34481442

RESUMEN

Brief information about the causes of depressive disorders in COVID-19 and general strategies of their treatment is presented. According to the biopsychosocial model of the development of mental diseases, depressive disorders in COVID-19 develop due to the toxic effect of the coronavirus on nervous system and other organism systems, possible side-effects of COVID-19 therapy, the psychogenic effect of excessive and inaccurate information about the coronavirus infection and the consequences of its spread, adverse social changes during the pandemic. If infection with the SARS-CoV-2 did not develop, depressive disorders may arise due to psychogenic information and negative social influences. If coronavirus infection is present, depressive disorders can manifest during the acute period of COVID-19 and after recovery from COVID-19. Depressive disorders may occur for the first time in a patient with COVID-19 or infection can aggravate depression that has been in remission. Care should consistently include psychosocial activities, psychocorrection and psychopharmacotherapy. For the prevention of onset of depressive disorders, it is better to implement social-hygienic and psychological-pedagogical measures. Psychotherapy and psychopharmacotherapy become more important in the development of clinically expressed depressive disorders.


Asunto(s)
COVID-19/psicología , Trastorno Depresivo , Depresión , Trastorno Depresivo/etiología , Trastorno Depresivo/terapia , Humanos , Pandemias , Psicoterapia
3.
Z Psychosom Med Psychother ; 67(3): 271-289, 2021 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-34524061

RESUMEN

Sleep disorders reduce the therapeutic success of inpatient psychosomatic treatments for depressive disorders Objective: What influence do difficulties in falling and staying asleep in patients with depressive disorders have on the success of psychosomatic treatment? Method: The Data were collected in a naturalistic, multicenter observational study (STOP-D) at the beginning (T1), the end (T2) and six months later after discharge (T3). The sample consisted of female patients with depressive disorders (N = 487) who were treated for M = 61.7 days (SD = 26.8). An insomnia scale with a total of seven items was created subsequently to T1 from Items of the Beck Depression Inventory (BDI-I), from the Hamilton Depression Scale (HAMD) and from the Global Severe Index (GSI) from the Symptom Checklist 90 (SCL-90-R). Then groups were formed on changes in insomnia symptoms from T1 to T2. These two groups "sleep improver" and "sleep deteriorators" were tested by analysis of variance. Results: The subsequently constructed insomnia scale showed good psychometric characteristics in the performed analyses. Patients who reported an improvement in their sleep disturbances during inpatient psychosomatic treatment had significantly lower depression scores in the self-evaluation inventories (BDI-I und SCL-90-R) than patients without improvements in their sleep patterns. This effect was even more pronounced for the catamnestic period. Discussion: Insomnia symptoms in depressed female patients can be an important indicator of the effect of inpatient psychosomatic treatment and can have negative impact on the sustainability of the therapy success.


Asunto(s)
Trastorno Depresivo , Trastornos del Sueño-Vigilia , Depresión , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/terapia , Femenino , Humanos , Pacientes Internos , Escalas de Valoración Psiquiátrica , Trastornos Psicofisiológicos/diagnóstico , Trastornos Psicofisiológicos/terapia , Trastornos del Sueño-Vigilia/terapia
4.
Lancet Psychiatry ; 8(10): 909-918, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34537101

RESUMEN

Guidance is scarce on whether and how to involve parents in treatment for anxiety and depressive disorders in children and young people. We did a scoping review of randomised controlled trials of psychological interventions for anxiety and depressive disorders in children and young people, in which parents were involved in treatment, to identify how parents and carers have been involved in such treatments, how this relates to both child and broader outcomes, and where research should focus. We identified 73 trials: 62 focused on anxiety and 11 on depressive disorders. How parents were involved in treatments varied greatly, with at least 13 different combinations of ways of involving parents in the anxiety trials and seven different combinations in the depression trials. Including parents in treatment did not impair children's and young people's outcomes, but the wide variability in how they were involved prevents clarity about why some trials favoured parent involvement and others did not. Studies must consider the long-term and wider benefits beyond children's and young people's mental health, such as enhanced engagement, family wellbeing, and economic gains.


Asunto(s)
Trastornos de Ansiedad/terapia , Trastorno Depresivo/terapia , Padres/psicología , Adolescente , Niño , Humanos , Evaluación de Resultado en la Atención de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto
5.
PLoS One ; 16(8): e0255594, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34352012

RESUMEN

INTRODUCTION: Implementation of evidence-based care for heavy drinking and depression remains low in global health systems. We tested the impact of providing community support, training, and clinical packages of varied intensity on depression screening and management for heavy drinking patients in Latin American primary healthcare. MATERIALS AND METHODS: Quasi-experimental study involving 58 primary healthcare units in Colombia, Mexico and Peru randomized to receive: (1) usual care (control); (2) training using a brief clinical package; (3) community support plus training using a brief clinical package; (4) community support plus training using a standard clinical package. Outcomes were proportion of: (1) heavy drinking patients screened for depression; (2) screen-positive patients receiving appropriate support; (3) all consulting patients screened for depression, irrespective of drinking status. RESULTS: 550/615 identified heavy drinkers were screened for depression (89.4%). 147/230 patients screening positive for depression received appropriate support (64%). Amongst identified heavy drinkers, adjusting for country, sex, age and provider profession, provision of community support and training had no impact on depression activity rates. Intensity of clinical package also did not affect delivery rates, with comparable performance for brief and standard versions. However, amongst all consulting patients, training providers resulted in significantly higher rates of alcohol measurement and in turn higher depression screening rates; 2.7 times higher compared to those not trained. CONCLUSIONS: Training using a brief clinical package increased depression screening rates in Latin American primary healthcare. It is not possible to determine the effectiveness of community support on depression activity rates due to the impact of COVID-19.


Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Alcohólicos/psicología , Depresión/terapia , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/prevención & control , Intoxicación Alcohólica/psicología , Alcoholismo/diagnóstico , Colombia/epidemiología , Comorbilidad , Atención a la Salud , Depresión/psicología , Trastorno Depresivo/psicología , Trastorno Depresivo/terapia , Femenino , Humanos , Masculino , Tamizaje Masivo/métodos , México/epidemiología , Persona de Mediana Edad , Perú/epidemiología , Atención Primaria de Salud/métodos , Atención Primaria de Salud/tendencias , Derivación y Consulta , Detección de Abuso de Sustancias/métodos
6.
BMC Psychiatry ; 21(1): 423, 2021 08 24.
Artículo en Inglés | MEDLINE | ID: mdl-34429098

RESUMEN

BACKGROUND: Depressive disorders are common in adolescence and are associated with a wide range of negative long-term outcomes. Highly controlled randomized controlled trials (RCT) provide considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) as a treatment for depression, but studies examining the effectiveness of CBT in clinical settings are very rare . METHODS: In the present observational study, the changes achieved through routine CBT in adolescents with depressive disorders treated in a clinical setting in terms of a university outpatient clinic were analyzed, and compared to a historical control group of adolescents with depressive disorders who had received treatment as usual. At the start and end of treatment (pre- and post-assessment), parent and self-ratings of the German versions of the Youth Self-Report (YSR), the Child Behavior Checklist (CBCL) and rating scales for depressive symptoms (FBB-DES, SBB-DES) were assessed. A total of 331 adolescents aged 11-18 years with complete data were assessed for the main analysis. RESULTS: The analysis yielded small to large pre-post effect sizes (Cohen's d) for the total sample (d = 0.33 to d = 0.82) and large effect sizes for adolescents who were rated in the clinical range on each (sub) scale at the start of treatment (d = 0.85 to d = 1.30). When comparing patients in the clinical range with historical controls, medium to large net effect sizes (d = 0.53 to d = 2.09) emerged for the total scores in self- and parent rating. However, a substantial proportion of the sample remained in the clinical range at the end of treatment. CONCLUSIONS: These findings suggest that CBT is effective for adolescents with depressive disorders when administered under routine care conditions, but the results must be interpreted with caution due to the lack of a direct control condition. TRIAL REGISTRATION: DRKS, DRKS00021518 . Registered 27 April 2020 - Retrospectively registered, http://drks.de.


Asunto(s)
Terapia Cognitivo-Conductual , Trastorno Depresivo , Adolescente , Niño , Trastorno Depresivo/terapia , Humanos , Padres , Autoinforme
7.
Biomolecules ; 11(7)2021 07 07.
Artículo en Inglés | MEDLINE | ID: mdl-34356624

RESUMEN

The brain-gut-microbiome axis is a bidirectional communication pathway between the gut microbiota and the central nervous system. The growing interest in the gut microbiota and mechanisms of its interaction with the brain has contributed to the considerable attention given to the potential use of probiotics, prebiotics and postbiotics in the prevention and treatment of depressive disorders. This review discusses the up-to-date findings in preclinical and clinical trials regarding the use of pro-, pre- and postbiotics in depressive disorders. Studies in rodent models of depression show that some of them inhibit inflammation, decrease corticosterone level and change the level of neurometabolites, which consequently lead to mitigation of the symptoms of depression. Moreover, certain clinical studies have indicated improvement in mood as well as changes in biochemical parameters in patients suffering from depressive disorders.


Asunto(s)
Encéfalo/metabolismo , Trastorno Depresivo , Microbioma Gastrointestinal , Prebióticos , Probióticos/uso terapéutico , Encéfalo/microbiología , Trastorno Depresivo/metabolismo , Trastorno Depresivo/microbiología , Trastorno Depresivo/terapia , Humanos , Inflamación/metabolismo , Inflamación/microbiología
8.
Medicine (Baltimore) ; 100(27): e26539, 2021 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-34232192

RESUMEN

ABSTRACT: Collaborative care - primary care models combining care management, consulting behavioral health clinicians, and registries to target mental health treatment - is a cost-effective depression treatment model, but little is known about uptake of collaborative care in a national setting. Alternative payment models such as accountable care organizations (ACOs), in which ACOs are responsible for quality and cost for defined patient populations, may encourage collaborative care use.Determine prevalence of collaborative care implementation among ACOs and whether ACO structure or contract characteristics are associated with implementation.Cross-sectional analysis of 2017-2018 National Survey of ACOs (NSACO). Overall, 55% of ACOs returned a survey (69% of Medicare, 36% of non-Medicare ACOs); 48% completed at least half of core survey questions. We used logistic regression to examine the association between implementation of core collaborative care components - care management, a consulting mental health clinician, and a patient registry to track mental health symptoms - and ACO characteristics.Four hundred five National Survey of ACOs respondents answering questions on collaborative care implementation.Only 17% of ACOs reported implementing all collaborative care components. Most reported using care managers (71%) and consulting mental health clinicians (58%), =just 26% reported using patient registries. After adjusting for multiple ACO characteristics, ACOs responsible for mental health care quality measures were 15 percentage points (95% CI 5-23) more likely to implement collaborative care.Most ACOs are not utilizing behavioral health collaborative care. Including mental health care quality measures in payment contracts may facilitate implementation of this cost-effective model. Improving provider capacity to track and target depression treatment with patient registries is warranted as payment contracts focus on treatment outcomes.


Asunto(s)
Organizaciones Responsables por la Atención/organización & administración , Trastorno Depresivo/terapia , Manejo de la Enfermedad , Atención Primaria de Salud/métodos , Estudios Transversales , Humanos , Estudios Retrospectivos
9.
Curr Opin Psychiatry ; 34(5): 448-459, 2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-34224469

RESUMEN

PURPOSE OF REVIEW: Depression is a prevalent comorbidity in cancer that significantly increases the risk for numerous negative health outcomes. This review updates the current evidence base for management of depression in cancer, highlighting new research directions based on the inflammatory hypothesis of depression. RECENT FINDINGS: Research on pharmacotherapy and psychotherapy for depression in cancer has shown mixed efficacy partly because of methodological issues arising from the phenomenology of depression in cancer. After decades of stagnancy, more recent high-quality clinical trials are beginning to provide an evidence base to guide treatment. Inflammatory cytokine-associated depression is a subtype of depression that may have particular relevance in cancer, opening new avenues to explore therapeutic targets and biobehavioral impacts of interventions, which may improve cancer outcomes. SUMMARY: The continuum of severity in cancer-related depression is important to consider in management approaches. Choice of treatment should be personalized to the patient and their symptom profile as there is currently insufficient evidence to recommend any particular medication or psychotherapy over another. Psychological interventions should be considered first line for mild-to-moderate depression, and pharmacological treatment added for more severe depression, which can be optimally delivered within a collaborative care model. VIDEO ABSTRACT: http://links.lww.com/YCO/A62.


Asunto(s)
Antidepresivos/uso terapéutico , Depresión/terapia , Neoplasias , Psicoterapia/métodos , Antineoplásicos/uso terapéutico , Terapia Combinada , Comorbilidad , Depresión/etiología , Trastorno Depresivo/etiología , Trastorno Depresivo/terapia , Humanos , Neoplasias/complicaciones , Neoplasias/tratamiento farmacológico , Neoplasias/psicología
11.
Ther Umsch ; 78(6): 299-304, 2021 Aug.
Artículo en Alemán | MEDLINE | ID: mdl-34291664

RESUMEN

Post stroke depression Abstract. Post stroke depression is a common psychiatric disorder after a cerebrovascular insult. It effects the outcome of the rehabilitation after the stroke and leads to an increased mortality. The symptomatic description of the depressive symptoms is done according to the ICD-10 criteria. The following article aims to provide an overview of the etiologic theories, diagnostic approaches, and therapeutic strategies regarding PSD.


Asunto(s)
Trastorno Depresivo , Accidente Cerebrovascular , Depresión/diagnóstico , Depresión/etiología , Depresión/terapia , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/etiología , Trastorno Depresivo/terapia , Humanos , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/terapia
13.
Prax Kinderpsychol Kinderpsychiatr ; 70(5): 445-464, 2021 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-34187341

RESUMEN

Depressive disorders in early childhood are associated with high psychosocial impairment and tend to remain stable over time without adequate treatment. Short-term psychoanalytic therapy is a common form of child psychotherapy, yet there is a lack of empirical evaluation of this approach for young children with depressive disorders. Therefore, this secondary evaluation of a study on the treatment of anxiety disorders used an uncontrolled pre-post design in a clinical setting to investigate whether children with depressive comorbidity would evidence significant diagnostic and symptomatic remission after treatment with manualized short-term Psychoanalytic Child Therapy (PaCT). Nineteen children who had an anxiety disorder and a (subclinical) depressive disorder (assessed with the Preschool Age Psychiatric Assessment using DSM-IV criteria) were treated with PaCT. After treatment, 15 of 19 children (78.94 %) were remitted and 15 of 17 children (88.24 %; 2 were lost to follow-up) were free of depressive disorders at the 6-month follow-up. Further analyses revealed significant effects for pre- to post and pre- to follow-up comparisons regarding internalizing symptoms and overall problems using parent- and (nursery-)teacher-ratings. These results suggest that short-term PaCT shows promise as a treatment for childhood depressive disorders.


Asunto(s)
Trastorno Depresivo , Terapia Psicoanalítica , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/terapia , Niño , Preescolar , Depresión , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/terapia , Humanos , Proyectos Piloto
14.
Lancet Psychiatry ; 8(6): 500-511, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33957075

RESUMEN

BACKGROUND: Internet cognitive behavioural therapy (iCBT) is a viable delivery format of CBT for depression. However, iCBT programmes include training in a wide array of cognitive and behavioural skills via different delivery methods, and it remains unclear which of these components are more efficacious and for whom. METHODS: We did a systematic review and individual participant data component network meta-analysis (cNMA) of iCBT trials for depression. We searched PubMed, PsycINFO, Embase, and the Cochrane Library for randomised controlled trials (RCTs) published from database inception to Jan 1, 2019, that compared any form of iCBT against another or a control condition in the acute treatment of adults (aged ≥18 years) with depression. Studies with inpatients or patients with bipolar depression were excluded. We sought individual participant data from the original authors. When these data were unavailable, we used aggregate data. Two independent researchers identified the included components. The primary outcome was depression severity, expressed as incremental mean difference (iMD) in the Patient Health Questionnaire-9 (PHQ-9) scores when a component is added to a treatment. We developed a web app that estimates relative efficacies between any two combinations of components, given baseline patient characteristics. This study is registered in PROSPERO, CRD42018104683. FINDINGS: We identified 76 RCTs, including 48 trials contributing individual participant data (11 704 participants) and 28 trials with aggregate data (6474 participants). The participants' weighted mean age was 42·0 years and 12 406 (71%) of 17 521 reported were women. There was suggestive evidence that behavioural activation might be beneficial (iMD -1·83 [95% credible interval (CrI) -2·90 to -0·80]) and that relaxation might be harmful (1·20 [95% CrI 0·17 to 2·27]). Baseline severity emerged as the strongest prognostic factor for endpoint depression. Combining human and automated encouragement reduced dropouts from treatment (incremental odds ratio, 0·32 [95% CrI 0·13 to 0·93]). The risk of bias was low for the randomisation process, missing outcome data, or selection of reported results in most of the included studies, uncertain for deviation from intended interventions, and high for measurement of outcomes. There was moderate to high heterogeneity among the studies and their components. INTERPRETATION: The individual patient data cNMA revealed potentially helpful, less helpful, or harmful components and delivery formats for iCBT packages. iCBT packages aiming to be effective and efficient might choose to include beneficial components and exclude ones that are potentially detrimental. Our web app can facilitate shared decision making by therapist and patient in choosing their preferred iCBT package. FUNDING: Japan Society for the Promotion of Science.


Asunto(s)
Terapia Cognitivo-Conductual , Trastorno Depresivo/terapia , Internet , Trastorno Depresivo/psicología , Humanos , Metaanálisis en Red , Evaluación de Resultado en la Atención de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto , Análisis de Sistemas
15.
Medicine (Baltimore) ; 100(20): e26013, 2021 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-34011102

RESUMEN

BACKGROUND: Post-stroke depression (PSD) is the most common mental health issue, affecting approximately 33% of stroke survivors. Tuina and acupuncture treatments are often combined to treat PSD; however, there has been no meta-analysis on their synergistic effect. Therefore, we aimed to perform a systematic review and meta-analysis to estimate the effectiveness of Tuina and acupuncture in PSD treatment. METHODS: The following electronic databases will be searched: PubMed, the Cochrane Library, Embase, Web of Science, Medline, CNKI, Chinese Biomedical Literature Database, VIP, and Wan Fang databases. We will consider articles published between database initiation and April 2021. Clinical randomized controlled trials related to Tuina combined with acupuncture for post-stroke depression will be included in the study. Language is limited to Chinese and English. Research selection, data extraction, and research quality assessment were independently completed by 2 researchers. Data were synthesized using a fixed effect model or random effect model, depending on the heterogeneity test. The Hamilton depression rating scale (HDRS) and effective rate were the primary outcomes. The post-stroke depression rating scale (PSDRS), patient health questionnaire-9 (PHQ-9), and the incidence of adverse events will also be assessed as secondary outcomes. RevMan V.5.4 statistical software will be used for meta-analysis. If it is not appropriate for a meta-analysis, a descriptive analysis will be conducted. Data synthesis uses the risk ratio and the standardized or weighted average difference of continuous data to represent the results. RESULTS: This study provides a high-quality synthesis to assess the effectiveness and safety of Tuina for post-stroke depression. CONCLUSION: This systematic review will provide evidence to determine whether Tuina plus acupuncture is an effective and safe intervention for patients with post-stroke depression. ETHICS AND DISSEMINATION: The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences. SYSTEMATIC REVIEW REGISTRATION: INPLASY202140098.


Asunto(s)
Terapia por Acupuntura , Trastorno Depresivo/terapia , Masaje , Accidente Cerebrovascular/psicología , Trastorno Depresivo/etiología , Humanos
16.
Medicine (Baltimore) ; 100(20): e26044, 2021 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-34011116

RESUMEN

BACKGROUND: Previous meta-analyses have examined the clinical efficacy and acceptability of deep brain stimulation (DBS) compared with sham therapy or paired active therapy. However, the absence of head-to-head clinical trials with some treatment comparisons creates uncertainty for decision makers. Thus, to provide new evidence-based medical evidence for clinical treatment, we undertook a meta-analysis to assess the efficacy and safety of DBS in patients with depression based on high-quality randomized controlled studies. METHODS: The protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement guidelines. PubMed/Medline and EMBASE will be searched before May 2021 for all studies, using various combinations of the following free text and key terms: deep brain stimulation; depression; random. No language restrictions will be applied. The method of data extraction will follow the approach outlined by the Cochrane Handbook for Systematic Reviews of Interventions. Review Manager software 5.3 is used for the meta-analysis. The quality of randomized trials will be assessed by Cochrane risk of bias tool for randomized controlled trials. RESULTS: The results of our review will be reported strictly following the PRISMA criteria and the review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/Q5B3S.


Asunto(s)
Estimulación Encefálica Profunda , Trastorno Depresivo/terapia , Estudios de Factibilidad , Humanos , Resultado del Tratamiento
17.
BMC Psychiatry ; 21(1): 243, 2021 05 08.
Artículo en Inglés | MEDLINE | ID: mdl-33964899

RESUMEN

BACKGROUND: Exercise is now recommended as a primary treatment for mild-moderate depression in Canada. The 'Exercise and Depression Toolkit' was developed to help health care providers (HCP) integrate these treatment guidelines into practice. The purpose of this study was to evaluate acceptability and perceived effectiveness of the toolkit in practice by HCPs working with individuals with depression. METHODS: A case study design was utilized. The toolkit was given to 6 HCPs to use in practice for 4 weeks. Pre- and post-intervention phone interviews were conducted, and weekly logs were provided to track use and satisfaction of interactions with individuals with depression when using the toolkit. The study was conceptually guided by a hybrid theoretical approach using the Diffusion of Innovation Theory and the Theoretical Framework of Acceptability. RESULTS: All HCPs used the toolkit at least once. Participants viewed their interactions when using the toolkit to be successful (considering individuals' receptiveness, its usefulness and general satisfaction.) The average success score for all participants was 5.5/7. HCPs found the toolkit to be acceptable. All participants (n = 6) viewed the toolkit as having relative advantage in helping them to discuss exercise with individuals with depression, and as relatively simple and easy to use (not complex) and adaptable to their practice needs (having trialability). Participants liked the toolkit and had mostly positive things to say about it. Participants had mixed feelings about whether changes in the people they worked with (such as mood and activity levels) could be observed (observability) and whether the toolkit changed their belief in their ability to recommend or discuss exercise (self-efficacy). Recommended dissemination strategies were adopted in promoting the toolkit. CONCLUSIONS: Future work should address observability and the ability for health care providers to see other providers using it, as well as effectiveness considering outcomes for people with depression such as mood and activity changes. The results of this initial evaluation seem promising for uptake and future adoption of the toolkit by health care providers working with adults with depression in Canada.


Asunto(s)
Depresión , Trastorno Depresivo , Adulto , Canadá , Depresión/terapia , Trastorno Depresivo/terapia , Ejercicio Físico , Personal de Salud , Humanos
18.
Oxid Med Cell Longev ; 2021: 6678276, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33859781

RESUMEN

Accumulating evidence indicates that dysfunction of the glutamatergic neurotransmission has been widely involved in the pathophysiology and treatment of depression. Photobiomodulation therapy (PBMT) has been demonstrated to regulate neuronal function both in vitro and in vivo. Herein, we aim to investigate whether the antidepressant phenotype of PBMT is associated with the improvement of glutamatergic dysfunction and to explore the mechanisms involved. Results showed that PBMT decreased extracellular glutamate levels via upregulation of glutamate transporter-1 (GLT-1) and rescued astrocyte loss in the cerebral cortex and hippocampus, which also alleviated dendritic atrophy and upregulated the expression of AMPA receptors on the postsynaptic membrane, ultimately exhibiting behaviorally significant antidepressant effects in mice exposed to chronic unpredictable mild stress (CUMS). Notably, PBMT also obtained similar antidepressant effects in a depressive mouse model subcutaneously injected with corticosterone (CORT). Evidence from in vitro mechanistic experiments demonstrated that PBMT treatment significantly increased both the GLT-1 mRNA and protein levels via the Akt/NF-κB signaling pathway. NF-κB-regulated transcription was in an Akt-dependent manner, while inhibition of Akt attenuated the DNA-binding efficiency of NF-κB to the GLT-1 promoter. Importantly, in vitro, we further found that PKA activation was responsible for phosphorylation and surface levels of AMPA receptors induced by PBMT, which is likely to rescue excitatory synaptic transmission. Taken together, our research suggests that PBMT as a feasible therapeutic approach has great potential value to control the progression of depression.


Asunto(s)
Trastorno Depresivo/terapia , Ácido Glutámico/efectos adversos , Terapia por Luz de Baja Intensidad/métodos , Animales , Modelos Animales de Enfermedad , Masculino , Ratones
19.
MMWR Morb Mortal Wkly Rep ; 70(13): 490-494, 2021 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-33793459

RESUMEN

The spread of disease and increase in deaths during large outbreaks of transmissible diseases is often associated with fear and grief (1). Social restrictions, limits on operating nonessential businesses, and other measures to reduce pandemic-related mortality and morbidity can lead to isolation and unemployment or underemployment, further increasing the risk for mental health problems (2). To rapidly monitor changes in mental health status and access to care during the COVID-19 pandemic, CDC partnered with the U.S. Census Bureau to conduct the Household Pulse Survey (HPS). This report describes trends in the percentage of adults with symptoms of an anxiety disorder or a depressive disorder and those who sought mental health services. During August 19, 2020-February 1, 2021, the percentage of adults with symptoms of an anxiety or a depressive disorder during the past 7 days increased significantly (from 36.4% to 41.5%), as did the percentage reporting that they needed but did not receive mental health counseling or therapy during the past 4 weeks (from 9.2% to 11.7%). Increases were largest among adults aged 18-29 years and among those with less than a high school education. HPS data can be used in near real time to evaluate the impact of strategies that address mental health status and care of adults during the COVID-19 pandemic and to guide interventions for groups that are disproportionately affected.


Asunto(s)
Ansiedad/epidemiología , Ansiedad/terapia , COVID-19/psicología , Trastorno Depresivo/epidemiología , Trastorno Depresivo/terapia , Servicios de Salud Mental/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Socioeconómicos , Estados Unidos/epidemiología , Adulto Joven
20.
Adv Exp Med Biol ; 1305: 351-374, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33834409

RESUMEN

A specific brief psychotherapeutic intervention aimed at empowering psychological well-being, the so-called Well-Being Therapy (WBT), has been manualized in 2016 by Giovanni Fava and has shown to be effective in randomized controlled trials. WBT is based on the multidimensional model of psychological well-being developed by Marie Jahoda which encompasses environmental mastery, personal growth, purpose in life, autonomy, self-acceptance, positive relations with others, and balance of psychic forces. WBT aims at promoting the achievement of an optimal-balanced functioning between the dimensions of psychological well-being, and such a balance is subsumed under the rubric of euthymia. There are evidences that WBT may be a suited clinical approach for second- or third-line treatment of depressive disorders with particular reference to decreasing vulnerability to relapse and modulating psychological well-being and mood. It has been also proposed a role of WBT in depressive disorders in clinical conditions such as treatment resistance, loss of antidepressant clinical efficacy, persistent post-withdrawal disorders, trauma exposure, and medical disease comorbidity. The present chapter provides an overview of the possible applications of WBT as treatment of depressive disorders.


Asunto(s)
Antidepresivos , Trastorno Depresivo , Afecto , Enfermedad Crónica , Trastorno Depresivo/terapia , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
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