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1.
J Affect Disord ; 321: 59-65, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36283536

RESUMO

BACKGROUND: The prevalence of depression symptoms among U.S. adults increased dramatically during the early months of the COVID-19 pandemic. We sought to understand the impact of the pandemic on people with a history of depression. METHODS: In June 2020, a national sample of 5023 U.S. adults, including 760 reporting past/current diagnoses of depression, completed survey measures related to the COVID experience, coping, anxiety, depression, and PTSD. RESULTS: After adjusting for sociodemographic characteristics, a history of depression increased the odds of negative effects of pandemic on multiple aspects of life: routines, access to mental health treatment, alcohol use, prescription painkiller use, and other drug use. Those with a history of depression also scored significantly higher on the PHQ-8, GAD-7, and PDS-5 (all ps < 0.0001). Greater use of adaptive coping strategies was significantly associated with lower scores, and greater use of maladaptive strategies with higher scores. Individuals reporting a history of depression reported greater use of both adaptive and maladaptive strategies. CONCLUSIONS: Adaptive coping strategies appear to be protective and help regulate symptomatology, suggesting that particular focus during the clinical encounter on developing tools to promote well-being, alleviate stress, and decrease perceptions of helplessness could mitigate the effects.


Assuntos
COVID-19 , Humanos , Adulto , Pandemias , Depressão/epidemiologia , Depressão/psicologia , Adaptação Psicológica , Ansiedade/epidemiologia
2.
J Affect Disord ; 321: 108-113, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36283537

RESUMO

BACKGROUND: This study aimed to investigate the association between smartphone overdependence and generalized anxiety disorder among South Korean adolescents. METHODS: Participants were selected from the Korean Youth Health Behavior Survey 2020. The primary dependent variable was the generalized anxiety disorder that was measured based on seven item instrument (GAD-7). The main exposure of interest was the smartphone overdependence using the integrated scale developed by the National Information Society Agency in Korea. Weighted chi-square test and multiple logistic regression were used to assess the association between smartphone overdependence and generalized anxiety disorder. RESULTS: The final participants comprised of 54,948 middle and high school students. 13,775 students (25.1 %) were classified as the smartphone overdependence group. Of those who reported overly dependent on smartphones, 2803 students (20.3 %) had generalized anxiety disorder. The risk for generalized anxiety disorder were 2.15 folds (95 % CI 2.01-2.30) higher among the overdependence group in compared to their counterparts. Specifically, the risk for generalized anxiety disorder increased when smartphone has negatively affected relationships with friends and colleagues (OR: 2.35, 95 % CI 2.08-2.64). The sensitivity of smartphone overdependence scale was verified and the risk for generalized anxiety disorder increased in magnitude with the severity of smartphone overdependence. CONCLUSION: The findings of the study showed significant association between smartphone overdependence and generalized anxiety disorder among South Korean adolescents. The negative changes in social relationships due to excessive smartphone use and the severity of overdependence accounted for the risk for generalized anxiety disorder.


Assuntos
Comportamento Aditivo , Smartphone , Humanos , Adolescente , República da Coreia/epidemiologia , Transtornos de Ansiedade/epidemiologia , Amigos , Ansiedade
3.
J Affect Disord ; 321: 83-95, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36302490

RESUMO

OBJECTIVE: To systematically evaluate the effectiveness of mindfulness-based interventions for ruminative thinking. METHODS: Cochrane Library, Web of Science, Embase, EBSCO, PubMed and Science Direct databases were searched to include randomized controlled trials of mindfulness-based interventions for rumination that met the criteria. The Rumination scale was used as the primary outcome indicator, and the secondary outcome indicator included the Mindfulness scale. An evaluation of bias risk was conducted to identify possible sources of bias based on methodological and clinical factors. Stata 16.0 software was used to perform meta-analysis, subgroup analysis, sensitivity analysis, meta-regression analysis and publication bias detection of the extracted data. RESULTS: A total of 61 studies with 4229 patients were included. Meta-analysis results revealed a significant intervention effect on ruminative thinking (SMD = -0.534, 95 % CI = [-0.675, -0.394], z = -7.449, P < 0.001). However, there was no significant difference between mindfulness-based interventions and CBT (SMD = 0.009, 95%CI = [-0.239, 0.258], z = 0.073, P = 0.941). Meta-analysis showed that mindfulness-based interventions significantly enhanced the level of mindfulness (SMD = 0.495, 95 % CI = [0.343, 0.647], z = 6.388, P < 0.001), while it was not significant compared to CBT (SMD = 0.158, 95%CI = [-0.087, 0.403], z = 1.266, P = 0.205). The two subgroups with >65 % (SMD = -0.534, 95%CI = [-0.681, -0.386], z = -7.081, P < 0.001) and 80 % (SMD = -0.462, 95%CI = [-0.590, -0.334], z = -7.071, P < 0.001) of females showed significant improvement in ruminative thinking. There were significant intervention effects for depression, students, cancer, healthy adults, and clinical patients. Significant intervention effects were demonstrated for various participant ages and intervention periods. CONCLUSION: This study confirmed the feasibility of mindfulness-based interventions in improving ruminative thinking and enhancing the level of mindfulness. However, the effectiveness of mindfulness-based interventions was not significant compared to CBT. The two subgroups with a higher proportion of females showed a more significant improvement in ruminative thinking, whereas there were no significant differences in participant characteristics, age, and the duration of intervention.


Assuntos
Atenção Plena , Neoplasias , Humanos , Adulto , Feminino , Atenção Plena/métodos , Ansiedade , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudantes
4.
J Affect Disord ; 320: 201-210, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36167247

RESUMO

OBJECTIVE: Generalized anxiety disorder (GAD) is a prevalent mental health disorder that often goes untreated. A core aspect of GAD is worry, which is associated with negative health outcomes, accentuating a need for simple treatments for worry. The present study leveraged pretreatment individual differences to predict personalized treatment response to a digital intervention. METHODS: Linear mixed-effect models were used to model changes in daytime and nighttime worry duration and frequency for 163 participants who completed a six-day worry postponement intervention. Ensemble-based machine learning regression and classification models were implemented to predict changes in worry across the intervention. Model feature importance was derived using SHapley Additive exPlanation (SHAP). RESULTS: Moderate predictive performance was obtained for predicting changes in daytime worry duration (test r2 = 0.221, AUC = 0.77) and nighttime worry frequency (test r2 = 0.164, AUC = 0.72), while poor predictive performance was obtained for nighttime worry duration and daytime worry frequency. Baseline levels of worry and subjective health complaints were most important in driving model predictions. LIMITATIONS: A complete-case analysis was leveraged to analyze the present data, which was collected from participants that were Dutch and majority female. CONCLUSIONS: This study suggests that treatment response to a digital intervention for GAD can be accurately predicted using baseline characteristics. Particularly, this worry postponement intervention may be most beneficial for individuals with high baseline worry but fewer subjective health complaints. The present findings highlight the complexities of and need for further research into daily worry dynamics and the personalizable utility of digital interventions.


Assuntos
Transtornos de Ansiedade , Ansiedade , Humanos , Feminino , Ansiedade/terapia , Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Transtornos de Ansiedade/psicologia , Autoavaliação Diagnóstica , Aprendizado de Máquina
5.
Behav Brain Res ; 437: 114128, 2023 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-36174841

RESUMO

While SSRIs are the current first-line pharmacotherapies against post-traumatic stress disorder (PTSD), they suffer from delayed onset of efficacy and low remission rates. One solution is to combine SSRIs with other treatments. Neuronal nitric oxide synthase (nNOS) has been shown to play a role in serotonergic signaling, and there is evidence of synergism between nNOS modulation and SSRIs in models of other psychiatric conditions. Therefore, in this study, we combined subchronic fluoxetine (Flx) with 7-nitroindazole (NI), a selective nNOS inhibitor, and evaluated their efficacy against anxiety-related behavior in an animal model of PTSD. We used the underwater trauma model to induce PTSD in rats. Animals underwent the open field (OFT) and elevated plus maze tests on days 14 (baseline) and 21 (post-treatment) after PTSD induction to assess anxiety-related behaviors. Between the two tests, the rats received daily intraperitoneal injections of 10 mg/kg Flx or saline, and were injected intraperitoneally before the second test with either 15 mg/kg NI or saline. The change in behaviors between the two tests was compared between treatment groups. Individual treatment with both Flx and NI had anxiogenic effects in the OFT. These effects were associated with modest increases in cFOS expression in the hippocampus. Combination therapy with Flx + NI did not show any anxiogenic effects, while causing even higher expression levels of cFOS. In conclusion, addition of NI treatment to subchronic Flx therapy accelerated the abrogation of Flx's anxiogenic properties. Furthermore, hippocampal activity, as evidenced by cFOS expression, was biphasically related to anxiety-related behavior.


Assuntos
Ansiolíticos , Inibidores Enzimáticos , Óxido Nítrico Sintase Tipo I , Inibidores de Captação de Serotonina , Transtornos de Estresse Pós-Traumáticos , Animais , Ratos , Ansiedade/metabolismo , Modelos Animais de Doenças , Fluoxetina/farmacologia , Fluoxetina/uso terapêutico , Hipocampo/metabolismo , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase Tipo I/antagonistas & inibidores , Óxido Nítrico Sintase Tipo I/metabolismo , Inibidores de Captação de Serotonina/farmacologia , Inibidores de Captação de Serotonina/uso terapêutico , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Transtornos de Estresse Pós-Traumáticos/metabolismo , Quimioterapia Combinada , Inibidores Enzimáticos/farmacologia , Inibidores Enzimáticos/uso terapêutico , Ansiolíticos/farmacologia , Ansiolíticos/uso terapêutico
6.
J Affect Disord ; 320: 340-347, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36174785

RESUMO

BACKGROUND: Although anxiety is highly prevalent in people with bipolar disorders and has deleterious impact on the course of the illness, past reviews have shown that many aspects of the topic remain under-researched. This scoping review aims to provide a comprehensive overview of the literature addressing anxiety in bipolar disorder (A-BD) between 2011 and 2020, assess if the interest in the topic has increased over the period and map the publication trends. METHODS: Three databases were systematically searched, and all articles were screened at the title/abstract and full text level based on inclusion and exclusion criteria. Of these, 1099 articles were included in the study. The annual number of articles on A-BD published between 2011 and 2020 was calculated and articles addressing it as a primary topic (n = 310) were classified into 4 categories and 11 subcategories to identify gaps in the knowledge. RESULTS: The results show no clear increase in the number of annual publications during the period and much of the available literature is of a descriptive nature. Less is known about the processes underlying the comorbidity and about treatment approaches. LIMITATIONS: Given the large scope of the research question, no quality assessment of the evidence was made. Only articles in English or French were considered. CONCLUSIONS: These results highlight the need to change the focus of research efforts to better understand and address this unique set of conditions in clinical settings.


Assuntos
Transtorno Bipolar , Humanos , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/terapia , Transtornos de Ansiedade/epidemiologia , Ansiedade/epidemiologia , Comorbidade
7.
Med Clin North Am ; 107(1): 131-142, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36402495

RESUMO

COVID-19 has increased the interest in the wellbeing of health professionals (HPs) as they have experienced stress, loss, and fatigue-related symptoms. Research evidence from previous epidemics points to an increase in the prevalence of affective, anxiety, and addictive disorders among them. HPs are trained to care for others and to recover from severe stressors. However, they tend to neglect self-care and have difficulties in seeking appropriate help when need it. This new scenario becomes an opportunity to promote a new culture of professionalism whereby caring for the caregivers becomes a priority both at a personal and institutional level.


Assuntos
COVID-19 , Humanos , Pessoal de Saúde , Cuidadores/psicologia , Ansiedade/epidemiologia , Transtornos de Ansiedade
8.
Med Clin North Am ; 107(1): 73-83, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36402501

RESUMO

Initial studies suggested that the fluctuations in the quantity, variety, and composition of the gut microbiota can significantly affect disease processes. This change in the gut microbiota causing negative health benefits was coined dysbiosis. Initial research focused on gastrointestinal illnesses. However, the gut microbiome was found to affect more than just gastrointestinal diseases. Numerous studies have proven that the gut microbiome can influence neuropsychiatric diseases such as Parkinson's disease, Alzheimer's disease, and multiple sclerosis.


Assuntos
Microbioma Gastrointestinal , Transtornos Mentais , Microbiota , Humanos , Ansiedade , Transtornos de Ansiedade
9.
Dimens Crit Care Nurs ; 42(1): 15-21, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36413641

RESUMO

BACKGROUND: Anxiety is a predictor of a bad prognosis in patients with coronary heart disease. Patients with coronary heart disease undergoing percutaneous coronary intervention (PCI) reported high levels of anxiety, yet little is known about changes in anxiety levels after this procedure. OBJECTIVE: The aim of this study was to examine changes in anxiety levels of patients undergoing PCI and identify differences in anxiety levels based on patients' demographics and clinical details. METHODS: A convenience sample of patients undergoing first-time elective PCI (N = 165) completed the Generalized Anxiety Disorder Scale at baseline (discharge time) and 6 months later. Paired samples t test was used to assess the changes in anxiety levels. The χ2 test was used to examine the pattern of changes between the 2 time points. Patients did not have access to cardiac rehabilitation. RESULTS: Six months after PCI, the anxiety level scores decreased significantly; mean scores for the baseline versus follow-up were 10.84 ± 5.98 versus 4.29 ± 6.02, respectively (P = .001). Only 18.2% of the patients had normal levels of anxiety at the baseline compared with 71.5% 6 months later. History of hospitalization after PCI, being a smoker, younger age, and low level of education were associated with higher levels of anxiety at follow-up. CONCLUSIONS: Although anxiety levels were reduced 6 months after PCI, assessing patients' anxiety levels and implementing psychoeducational interventions at follow-up should be incorporated to optimize the care of PCI patients, particularly for those who are younger, who are smokers, or with a low educational level.


Assuntos
Doença das Coronárias , Intervenção Coronária Percutânea , Humanos , Ansiedade , Escolaridade
10.
Behav Brain Res ; 437: 114160, 2023 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-36257559

RESUMO

Anxiety is a common emotional disorder in children. To understand its underlying mechanisms, chronic unpredictable stress (CUS) has been established as a stress model in zebrafish. By using the tall tank test, the stress response reliability could be improved in adult fish which has not been confirmed in larvae. In addition, the increasing evidences have shown that cerebellum plays important roles in anxiety. Whether CUS will affect cerebellar neuronal activity remains unknown. We found that CUS exposure to larvae (from 10 to 17 days post fertilization) induced anxiety-like behaviors and social cohesion impairments within 1-2 d after CUS, including a prolonged freezing time, an increased time spent at the bottom of tank, an increased thigmotaxis index, and an increased interindividual distance. Our results showed that the four behavioral tests were homogeneous, especially the tall tank test either anxiety-like behaviors or the basal locomotion. Furthermore, we found that CUS enhanced the excitability of cerebellar neurons, as the amplitude, frequency, time to peak and half-width of spontaneous firing significantly decreased, as well as the amplitude of excitatory post-synaptic current when compared with the control group. CUS also activated hyperpolarization-activated cyclic nucleotide-gated and potassium channels of cerebellar neurons. Multiple linear regression analysis showed that the total distance in bottom (tall tank test) was correlated positively with outward Na+-K+ currents (r = 0.848, P = 0.016), and the thigmotaxis index (open field test) correlated with action potential amplitude (r = 0.854, P = 0.030). Altogether, early life CUS transiently induced an anxiety-like behavior which could be more accurately assessed by combining the tall tank test with other behavior tests in young zebrafish. CUS increased the excitability of cerebellar neurons might provide new targets to treat emotional diseases such as anxiety.


Assuntos
Estresse Psicológico , Peixe-Zebra , Animais , Reprodutibilidade dos Testes , Ansiedade , Larva , Neurônios , Comportamento Animal
11.
Neuropharmacology ; 222: 109306, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36341808

RESUMO

Prolonged exposure (PE) therapy aiming to promote fear extinction is a useful treatment for post-traumatic stress disorder (PTSD). However, the mechanisms underlying fear extinction and effective methods used to promote fear extinction in PTSD are still lacking. In this study, we displayed dysfunctions of cyclic adenosine 3,5-monophosphate (cAMP)-protein kinase A (PKA), protein kinase B (Akt)/mammalian target of rapamycin (mTOR) and calcium signaling in peripheral serum of PTSD patients using bioinformatics analysis. Later, we confirmed the dysfunctions of cAMP-PKA, AKT/mTOR and calcium signaling in the hippocampus of PTSD mice. Moreover, the reduction of calpain1 in the hippocampus enhanced fear memory acquisition. Single activation of PKA by systemic application of rolipram (ROL) or meglumine cyclic adenylate (M-cAMP) before re-exposure promoted fear extinction and improved anxiety-like behavior in PTSD mice. Moreover, systemic application of ROL before re-exposure improved hippocampal brain-derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrkB) signaling and calpain1/AKT/mTOR signaling. Interestingly, the effects of activation of PKA could be partially blocked by TrkB antagonist, ANA-12 and mTOR inhibitor, RAPA. Finally, intranasal administration of ROL could also adjust the abnormality of fear memory and improve anxiety-like behaviors in PTSD mice. Collectively, activation of PKA could promote fear extinction, which correlated with the reduction of anxiety-like behavior. The mechanisms were related to the BDNF/TrkB and calpain1/AKT/mTOR signaling pathways. PKA activation might be a useful complementary therapy for PE in the symptom elimination of PTSD.


Assuntos
Medo , Transtornos de Estresse Pós-Traumáticos , Camundongos , Animais , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Proteínas Quinases Dependentes de AMP Cíclico , Proteínas Proto-Oncogênicas c-akt , Fator Neurotrófico Derivado do Encéfalo , Extinção Psicológica , Ansiedade/tratamento farmacológico , Serina-Treonina Quinases TOR , Rolipram , Sinalização do Cálcio , Adenosina , Mamíferos
12.
J Affect Disord ; 321: 279-289, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36367496

RESUMO

Migration is not an event, but an interactive process whereby individuals on the move make decisions in their social and political contexts. As such, one expects migrant mental health to change over time. To examine this relationship, we conducted a meta-analysis, the first to our knowledge, to identify the impact of migration phase and migration type on the prevalence of mental health in migrant populations. We searched PubMed, PsycInfo, and Embase for studies published between January 1, 2010, and January 1, 2020 (Prospero ID: 192751). We included studies with international migrants reporting prevalence rates for post-traumatic stress disorder (PTSD), depression, and/or anxiety. The authors extracted data from eligible studies and tabulated mental health prevalence rates, relevant migration condition (e.g., migration type or phase), and methods (e.g., sample size). Full text review resulted in n = 269 manuscripts included in the meta-analysis examining PTSD (n = 149), depression (n = 218), and anxiety (n = 104). Overall prevalence was estimated for PTSD (30.54 %, I2 = 98.94 %, Q = 10,443.6), depression (28.57 %, I2 = 99.17 %, Q = 13,844.34), and anxiety (25.30 %, I2 = 99.2 %, Q = 10,416.20). We also estimated the effect of methodological and migration factors on prevalence in PTSD, depression, and anxiety. Our findings reveal increased prevalence of mental health due to forced migration and being in the journey phase of migration, even when accounting for the influence of methods.


Assuntos
Migrantes , Humanos , Prevalência , Saúde Mental , Transtornos de Ansiedade/epidemiologia , Ansiedade/epidemiologia
13.
Behav Brain Res ; 437: 114104, 2023 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-36100011

RESUMO

Post-stroke depression (PSD) is a common neuropsychiatric complication of stroke, which seriously affects the quality of life and prognosis of patients. Nevertheless, the pathogenesis of PSD remains unclear. In our study, a PSD rat model was established by chronic restraint stress (CRS) combined with middle cerebral artery occlusion (MCAO). Depressive and anxiety-like behaviors were tested, as well as Neuronal loss and Apoptosis. The expression of synapse and p38 MAPK signaling pathway -relevant proteins was detected. Our data indicated that CRS combined with MCAO could induce depression-like and anxiety-like behaviors, which led to neuronal damage, apoptosis, and cellular loss in the left parietal cortex and left hippocampus. Furthermore, CRS combined with MCAO decreased synaptic plasticity in the parietal cortex and left hippocampus. We found that CRS combined with MCAO had activated the p38 MAPK signaling pathway, and decreased the expression of pathway-related proteins MKK6 and MKK3. These results suggested that CRS combined with MCAO could lead to depression-like behavior via neuronal damage, apoptosis and reduced synaptic plasticity, which might be related to the activation of the p38 MAPK pathway. Therefore, it provides novel ideas for the research on the intervention and prevention mechanisms of PSD.


Assuntos
Arteriopatias Oclusivas , Depressão , Infarto da Artéria Cerebral Média , Estresse Psicológico , Acidente Vascular Cerebral , Proteínas Quinases p38 Ativadas por Mitógeno , Animais , Ratos , Depressão/etiologia , Depressão/metabolismo , Depressão/psicologia , Modelos Animais de Doenças , Infarto da Artéria Cerebral Média/etiologia , Infarto da Artéria Cerebral Média/metabolismo , Infarto da Artéria Cerebral Média/patologia , Infarto da Artéria Cerebral Média/psicologia , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Qualidade de Vida , Ratos Sprague-Dawley , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/metabolismo , Acidente Vascular Cerebral/psicologia , Arteriopatias Oclusivas/etiologia , Arteriopatias Oclusivas/metabolismo , Sinapses/metabolismo , Transdução de Sinais , Restrição Física/efeitos adversos , Restrição Física/fisiologia , Restrição Física/psicologia , Doença Crônica , Estresse Psicológico/etiologia , Estresse Psicológico/metabolismo , Estresse Psicológico/psicologia , Apoptose , Ansiedade/etiologia , Ansiedade/metabolismo , Ansiedade/psicologia , Córtex Cerebral/metabolismo , Córtex Cerebral/patologia , Hipocampo/metabolismo , Hipocampo/patologia , Neurônios/metabolismo , Neurônios/patologia , Quinases de Proteína Quinase Ativadas por Mitógeno/metabolismo
14.
West J Nurs Res ; 45(1): 78-92, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35614567

RESUMO

This systematic review explores gender differences in adverse psychosocial and role-related outcomes of family caregivers of older adults with chronic illnesses. Data sources for the systematic review included CINAHL, PubMed, PsycINFO, and Google Scholar. Eligible primary research focused on examining gender-based differences in psychological and emotional outcomes (e.g., burden, depression, stress) among family caregivers of an older adult with chronic illness. In total, 16 studies were included in the review with most studies using a cross-sectional design and conducted outside of the United States. Studies reported on gender differences in health outcomes such as burden, stress, and anxiety. Women caregivers had overall higher negative outcomes, but men may have more intense difficulty during the initial caregiver transition phase. Resources to address caregiver health should consider the caregiver's gender. As the older adult population grows, more caregiver research is needed and future studies to include more male caregivers.


Assuntos
Ansiedade , Cuidadores , Humanos , Masculino , Feminino , Idoso , Cuidadores/psicologia , Estudos Transversais , Fatores Sexuais , Ansiedade/psicologia , Emoções
15.
J Affect Disord ; 320: 148-160, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36179778

RESUMO

BACKGROUND: An increasing number of research has documented the positive associations between psychological inflexibility (PI) and mental health problems (i.e., depressive, anxiety, and stress symptoms) during the COVID-19 pandemic. However, the documented associations have been inconsistent. This review thus aimed to quantitatively summarize primary research to gain better estimates of these associations. METHODS: A systematic literature review was conducted in six databases and three-level meta-analytic models were used to statistically synthesize effect sizes and to examine moderators of the associations between PI and depressive, anxiety, and stress symptoms. RESULTS: A total of 22 studies yielded 63 effect sizes on associations between PI and depressive, anxiety, or stress symptoms. The results of three separate meta-analyses revealed a large and significant association between PI and depressive (r = 0.580, 95 % CI [0.549; 0.775]), anxiety (r = 0.548, 95 % CI [0.468; 0.761]), and stress symptoms (r = 0.548, 95 % CI [0.506; 0.725]). The association between PI and depressive symptoms is stronger for males than for females, and the association between PI and stress symptoms varies by type of measure that primary studies use to assess PI and stress symptoms. LIMITATIONS: Temporal or causal conclusions are not allowed due to cross-sectional nature of the associations included in meta-analyses. Clinical samples with high levels of stress were underrepresented. CONCLUSIONS: PI seems an important risk factor for symptoms of depression, anxiety, and stress, and should therefore be targeted in interventions addressing mental health problems during the COVID-19 pandemic and beyond.


Assuntos
COVID-19 , Humanos , Masculino , Feminino , COVID-19/epidemiologia , Pandemias , Saúde Mental , Estudos Transversais , Ansiedade/psicologia , Depressão/psicologia
16.
J Affect Disord ; 320: 65-73, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36183816

RESUMO

BACKGROUND: The categorical approach to diagnosing mental disorders has been criticized for a number of reasons (e.g., high rates of comorbidity; larger number of diagnostic categories and combination). Diverse alternatives have been proposed using a hybrid or totally dimensional perspective. Despite the evidence supporting use of the Multidimensional Emotional Disorders Inventory (MEDI) for assessing the transdiagnostic dimensions of Emotional Disorders using a dimensional-categorical hybrid approach, no data exist on Spanish clinical samples. The present study explores the validity and reliability of the 49-item MEDI in a clinical sample and provides data for its use. METHODS: A total of 280 outpatients with emotional disorders attended in different Spanish public Mental Health Units in Spain filled out all questionnaires during the assessment phase and the MEDI again one week after. The instruments used evaluate four main constructs: personality, mood, anxiety and avoidance. RESULTS: The nine original factors were confirmed and showed adequate reliability (α: 0.66-0.91) and stability (r = 0.76-0.87). No differences in mean scores by sex were presented in any subscale (p ≥ .07). The MEDI subscales correlated significantly with the scales of each of the selected constructs (0.45 < r < 0.76). LIMITATIONS: The main limitations of this study were the limited sample size and not being able to count on MEDI scores post-transdiagnostic intervention. CONCLUSIONS: The MEDI demonstrates adequate reliability and validity. It allows to assess diverse symptoms efficiently, thus being of interest for clinical studies and practice.


Assuntos
Transtornos de Ansiedade , Transtornos do Humor , Humanos , Reprodutibilidade dos Testes , Transtornos do Humor/diagnóstico , Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Inquéritos e Questionários , Psicometria
17.
J Affect Disord ; 320: 230-240, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36183821

RESUMO

BACKGROUND: Interpersonal psychotherapy (IPT) has been widely used for depression. However, current studies of IPT have been restricted to depressive symptoms, and the results for improving social functioning were controversial. METHODS: A comprehensive literature search of randomized controlled trials (RCTs) was conducted through eleven databases. Data analysis was performed by RevMan5.3, and effects were summarized by using a random effects model of mean differences with 95 % confidence intervals. RESULTS: From 2443 records, eleven studies met inclusion and exclusion criteria were used for meta-analysis. The results showed that IPT had significant effects on improving social functioning (SMD: -0.53, 95 % CI: -0.80 to -0.26), reducing depression (SMD: -0.49, 95 % CI: -0.80 to -0.19) and anxiety (SMD: -0.90, 95 % CI: -1.28 to -0.52), but the effect on the overall functioning (SMD: -0.37, 95 % CI: -0.73 to -0.01) is not obvious. Moreover, subgroup analysis showed that IPT was effective in improving social functioning in adolescent depression (SMD: -0.35, 95 % CI: -0.58 to -0.13) and perinatal depression (SMD: -1.01, 95 % CI: -1.35 to -0.67), while there was no significant difference in the adult depression group (SMD: -0.39, 95 % CI: -1.05 to 0.27). LIMITATION: The blind method cannot be carried out in most studies due to the particularity of psychotherapy, heterogeneity in some results. CONCLUSION: IPT has a significant effect on improving social functioning and reducing depression and anxiety, while the effect on overall functioning requires further research. Overall, IPT is one of the effective nonpharmacological treatments for depression.


Assuntos
Psicoterapia Interpessoal , Humanos , Adulto , Adolescente , Gravidez , Feminino , Depressão/terapia , Interação Social , Psicoterapia/métodos , Ansiedade
18.
J Affect Disord ; 320: 348-352, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36183823

RESUMO

BACKGROUND: This epidemiological study described changes in the estimated prevalence of current pharmacological and/or psychotherapy-based treatment utilization among college students with depression only, anxiety only, or comorbid depression & anxiety. METHODS: A sample of 190,500 weighted responses was collected through the 2013-2019 Healthy Minds Study questionnaires. Annual prevalence estimates of depression only, anxiety only, or comorbid depression & anxiety were computed. Current use of therapy, pharmacological services, or dual treatment among students with depression and/or anxiety were examined via descriptive statistics. RESULTS: Estimated prevalence of college students who screened positive for depression only, anxiety only, and comorbid depression & anxiety escalated from 2013 to 2018-2019. When assessed individually, rates of currently using any psychiatric medication, participating in therapy, and engaging in concurrent medication & therapy services significantly rose among students with depression and/or anxiety. However, temporal trends in the current use of specific classes of psychiatric medications among young adults with depression only, anxiety only, or comorbid depression & anxiety differed by medication class. LIMITATIONS: This study was unable to assess psychiatric prescribing practices, depression or anxiety diagnoses, and prior mental health treatment. CONCLUSIONS: An increasing proportion of college students are reporting depression and/or anxiety symptoms as well as pharmacological and/or psychotherapy service utilization when comparing rates from 2013 to 2018-19. Although this may indicate increasing acceptability to disclose and seek treatment for problematic symptomology, continued surveillance of college populations is needed to identify students at risk for adverse psychiatric health outcomes, especially during the coronavirus disease 2019 pandemic.


Assuntos
COVID-19 , Depressão , Humanos , Adulto Jovem , Depressão/epidemiologia , Depressão/terapia , Depressão/psicologia , Ansiedade/epidemiologia , Ansiedade/terapia , Ansiedade/psicologia , Estudantes/psicologia , Universidades , Psicoterapia
19.
J Affect Disord ; 320: 353-359, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36191643

RESUMO

BACKGROUND: Brexanolone is currently the only treatment specifically approved for postpartum depression (PPD) in the United States, based on the results from one Phase 2 and two Phase 3 double-blind, randomized, controlled trials in the HUMMINGBIRD program. METHODS: Adults with PPD randomized to a 60-h infusion of brexanolone 90 µg/kg/h (BRX90) or placebo from the 3 trials were included in these post hoc analyses. Data on change from baseline (CFB) in the 17-item Hamilton Rating Scale for Depression (HAMD-17) total score, HAMD-17 Anxiety/Somatization and Insomnia subscales, and Clinical Global Impression of Improvement (CGI-I) scale were pooled. Response rates for HAMD-17 (≥50 % reduction from baseline) and CGI-I (score of 1 or 2) scales and time to response were analyzed. RESULTS: Patients receiving BRX90 (n = 102) versus placebo (n = 107) achieved a more rapid HAMD-17 response (median, 24 vs 36 h; p = 0.0265), with an Hour-60 cumulative response rate of 81.4 % versus 67.3 %; results were similar for time to CGI-I response (median, 24 vs 36 h; p = 0.0058), with an Hour-60 cumulative response rate of 81.4 % versus 61.7 %. CFB in HAMD-17 Anxiety/Somatization and Insomnia subscales also favored BRX90 versus placebo, starting at Hour 24 through Day 30 (all p < 0.05), and response rates for both subscales were higher with BRX90. LIMITATIONS: The study was not powered to assess exploratory outcomes. CONCLUSIONS: Brexanolone was associated with rapid improvement in depressive symptoms and symptoms of anxiety and insomnia compared with placebo in women with PPD. These data continue to support the use of brexanolone to treat adults with PPD.


Assuntos
Depressão Pós-Parto , Distúrbios do Início e da Manutenção do Sono , Humanos , Adulto , Feminino , Depressão Pós-Parto/tratamento farmacológico , Depressão , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Escalas de Graduação Psiquiátrica , Método Duplo-Cego , Ansiedade/tratamento farmacológico , Resultado do Tratamento
20.
J Affect Disord ; 320: 275-283, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36191642

RESUMO

BACKGROUND: To study the longitudinal impact of co-occurring mental health problems, and to identify vulnerable groups in need of mental health support during the COVID-19 pandemic. METHODS: Analyses were based on data from 681 French participants in the international COVID-19 Mental Health Study, collected at four times (05/2020-04/2021). Symptoms of depression, anxiety and post-traumatic stress disorder (PTSD) were assessed using the Patient Health Questionnaire 9, the Generalized Anxiety Disorder-7 and the PTSD Check List for DSM-5. We performed k-means for longitudinal data to build trajectories of adults' depression, anxiety and PTSD symptoms and identify subgroups psychologically vulnerable. We then assessed whether mental health trajectories were predicted by lockdown regulations. RESULTS: A high and a low cluster of mental health scores were identified. In both groups, mental health scores varied significantly across time. Levels of all mental health scores were lowest when COVID-19-related restrictions were lifted and highest when restrictions were in place, except for PTSD. No scores returned to the previous level or the initial level of mental health (p < 0.05). Participants with high levels of symptoms were characterized by younger age (OR: 0.98, 95 % CI: 0.97-0.99), prior history of mental disorders (OR: 3.46, 95 % CI: 2.07-5.82), experience of domestic violence (OR: 10.54, 95 % CI: 1.54-20.68) and medical issues (OR: 2.16, 95 % CI: 1.14-4.03). LIMITATIONS: Pre-pandemic data were not available and the sample was recruited mainly by snowball sampling. CONCLUSION: This study revealed subtle differences in the evolution of symptom trajectories during the first year of the Covid-19 pandemic, and highlighted several characteristics associated with the two clusters.


Assuntos
COVID-19 , Transtornos de Estresse Pós-Traumáticos , Humanos , Adulto , Pandemias , COVID-19/epidemiologia , Saúde Mental , Depressão/psicologia , Controle de Doenças Transmissíveis , Ansiedade/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
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