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1.
BMC Psychiatry ; 21(1): 416, 2021 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-34416868

RESUMO

BACKGROUND: In light of the ongoing opioid overdose crisis, there is an urgent need for research on the impacts of mental health among people presenting with concurrent pain and substance use. This study examined the effect of depressive symptoms on pain severity and functional interference among people who use drugs (PWUD) during a community-wide overdose crisis. METHODS: From December 1st 2016 to December 31st 2018, 288 participants in two cohort studies of PWUD in Vancouver, Canada completed interviewer-administered questionnaires that included the Brief Pain Inventory and PROMIS Emotional Distress-Depression instruments. Generalized linear regression modelling (GLM) was used to examine the cross-sectional effect of depressive symptoms and other confounding factors on pain severity and interference. RESULTS: Moderate to severe depressive symptoms were significantly associated with greater pain-related functional interference (adjusted ß = 1.24, 95% confidence interval [CI] = 0.33-2.15), but not significantly associated with greater average pain severity (adjusted ß = 0.22, 95% CI = - 0.3 - 0.82), when controlling for confounding variables. Reported daily heroin use (adjusted ß = 1.26, 95% CI = 0.47-2.05) and non-fatal overdose (adjusted ß = 1.02, 95% CI = 0.08-1.96) were also significantly associated with greater pain-related functional interference. CONCLUSIONS: In a substance-using population, greater pain-related functional interference was positively associated with depressive symptoms as well as overdose and daily heroin use. These findings emphasize the need to address the functional impact of pain, mental health comorbidity, and high-risk substance use that may contribute to overdose and other harms.


Assuntos
Depressão , Overdose de Drogas , Estudos de Coortes , Estudos Transversais , Depressão/complicações , Depressão/epidemiologia , Humanos , Dor/complicações , Dor/tratamento farmacológico , Dor/epidemiologia
2.
Int J Mol Sci ; 22(15)2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34360568

RESUMO

Multiple sclerosis (MS) is a chronic disease of the central nervous system that affects the brain and spinal cord. There are several disease courses in MS including relapsing-remitting MS (RRMS), primary progressive MS (PPMS), and secondary progressive MS (SPMS). Up to 50% of MS patients experience depressive disorders. Major depression (MD) is a serious comorbidity of MS. Many dysfunctions including neuroinflammation, peripheral inflammation, gut dysbiosis, chronic oxidative and nitrosative stress, and neuroendocrine and mitochondrial abnormalities may contribute to the comorbidity between MS and MD. In addition to these actions, medical treatment and microRNA (miRNA) regulation may also be involved in the mechanisms of the comorbidity between MS and MD. In the study, I review many common miRNA biomarkers for both diseases. These common miRNA biomarkers may help further explore the association between MS and MD.


Assuntos
Depressão/patologia , Regulação da Expressão Gênica , MicroRNAs/genética , Esclerose Múltipla/patologia , Animais , Depressão/complicações , Depressão/genética , Humanos , Esclerose Múltipla/complicações , Esclerose Múltipla/genética
3.
Psychol Aging ; 36(5): 667-676, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34351188

RESUMO

Comorbid depression and anxiety is linked to worse outcomes such as increased impairment, distress, and morbidity, as well as worse treatment outcomes. Transdiagnostic variables such as cognitive fusion are considered potential factors for explaining comorbidity. The aim of this study was to analyze the differences between symptom profiles of caregivers (comorbid, depressive, anxiety, and subclinical) in terms of demographic and contextual factors, stress variables, and cognitive fusion. Individual interviews were conducted with 553 caregivers of a relative with dementia. Sociodemographic variables, stressors, cognitive fusion, and depressive and anxiety symptoms were assessed. Caregivers were grouped into four symptom profiles, comorbid (n = 303), depressed (n = 40) anxiety (n = 86), and subclinical (n = 124), based on their depressive and anxiety symptoms. The likelihood of presenting a comorbid profile relative to the subclinical profile was higher in female caregivers. In addition, higher frequency of disruptive behaviors of the care recipient was a risk factor for presenting a comorbid profile relative to the other three profiles, and higher scores in cognitive fusion were a risk factor of comorbidity relative to the other profiles (anxiety, depressive, and subclinical). The findings suggest that the likelihood of presenting comorbid symptomatology is higher for female caregivers and those reporting higher levels of cognitive fusion and higher frequency of disruptive behaviors. These characteristics may describe a vulnerable profile of dementia family caregivers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Ansiedade/complicações , Cuidadores/psicologia , Cognição , Demência , Depressão/complicações , Estresse Psicológico/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer , Saúde da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
4.
Nutrients ; 13(7)2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34371931

RESUMO

The purpose of this study was to examine the independent and joint associations of acid-producing diets and depressive symptoms with physical health among breast cancer survivors. We studied a cohort of 2944 early stage breast cancer survivors who provided dietary, physical health, demographic, and lifestyle information at baseline, year 1, and year 4. We assessed the intakes of acid-producing diets via two commonly used dietary acid load scores: potential renal acid load (PRAL) and net endogenous acid production (NEAP). Physical health was measured using the Rand 36-Item Short Form Health Survey (SF-36), consisting of physical functioning, role limitation due to physical function, bodily pain, general health, and overall physical health subscales. Increased dietary acid load and depression were each independently and significantly associated with reduced physical health subscales and overall physical health. Further, dietary acid load and depression were jointly associated with worse physical health. For instance, depressed women with dietary acid load higher than median reported 2.75 times the risk (odds ratio = 2.75; 95% confidence interval: 2.18-3.47) of reduced physical function and 3.10 times the risk of poor physical health (odds ratio = 3.10; 95% confidence interval: 2.53-3.80) compared to non-depressed women with dietary acid load lower than median. Our results highlight the need of controlling acid-producing diets and the access of mental care for breast cancer survivors.


Assuntos
Ácidos/efeitos adversos , Afeto , Neoplasias da Mama/terapia , Sobreviventes de Câncer/psicologia , Depressão/complicações , Dieta/efeitos adversos , Saúde Mental , Ácidos/metabolismo , Adulto , Depressão/diagnóstico , Depressão/psicologia , Feminino , Nível de Saúde , Humanos , Concentração de Íons de Hidrogênio , Pessoa de Meia-Idade , Prognóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Fatores de Risco , Fatores de Tempo
5.
Medicine (Baltimore) ; 100(32): e26937, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397943

RESUMO

ABSTRACT: Retinal vessels share similar anatomical and physiological characteristics with the cerebral microvasculature, and abnormal cerebral blood flow is reportedly associated with depressive disorder. However, there is limited evidence regarding the relationship between depression and the risk of retinal vein occlusion (RVO). This study aimed to investigate the association between depression and the prospective risk of RVO using nationally representative longitudinal data. This retrospective, nationwide, population-based cohort study included 9,178,222 people aged 20 years or older who underwent the Korean National Health Screening Program examination in 2009. The depression group consisted of subjects whose initial diagnoses were made between 2009 and 2010 (n = 128,700). The predictive value for RVO was analyzed using multivariate Cox proportional hazard regression models.From the Kaplan-Meier curves, the depression group showed significantly higher RVO incidence probability, relative to the comparison group (P < .0001). After all confounding variables were adjusted, the hazard ratio of RVO in the depression group with or without recurrence was 1.2 (95% confidence interval [CI]: 1.076-1.338) and 1.087 (95% CI: 1.012-1.167), respectively, relative to the comparison group. This is the first nationwide, population-based, epidemiologic study that evaluated the association between depression and the risk of RVO development. The presence of depression was significantly associated with increased risks of RVO, and the recurrence of depression showed a higher RVO incidence probability.


Assuntos
Depressão/complicações , Vigilância da População , Oclusão da Veia Retiniana/etiologia , Adulto , Idoso , Depressão/epidemiologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Oclusão da Veia Retiniana/diagnóstico , Oclusão da Veia Retiniana/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
7.
BMC Res Notes ; 14(1): 284, 2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34301316

RESUMO

OBJECTIVES: Restless Legs Syndrome (RLS) is commonly known to cause morbidity in patients on hemodialysis, making them prone to chronic mental health illnesses such as depression and anxiety, and also adversely impact quality of life. In this study, we examined the association of quality of life, anxiety, and depression with restless leg syndrome in the hemodialysis patients at Karachi Institute of Kidney Diseases. RESULTS: About 26.7% of the participants reported RLS among the sample size Presence of RLS was not associated with quality of life, depression, and anxiety. However, p-values < 0.05 were significant for body-mass index (BMI), diabetes mellitus as a cause of end-stage renal disease, and serum albumin levels. Majority (82.5%) of the RLS-diagnosed patients had moderate to severe symptoms with 16 (40%) and 17 (42.5%) clients, respectively.


Assuntos
Síndrome das Pernas Inquietas , Ansiedade/complicações , Ansiedade/epidemiologia , Depressão/complicações , Humanos , Qualidade de Vida , Diálise Renal/efeitos adversos , Síndrome das Pernas Inquietas/complicações , Síndrome das Pernas Inquietas/epidemiologia
8.
Artigo em Chinês | MEDLINE | ID: mdl-34304465

RESUMO

Objective:Benign paroxysmal vertigo (BPV) and vestibular migraine (VM) are the most common causes of recurrent vertigo in children. The objective of this article is Tto investigate the clinical characteristic of anxiety and depression in children with BPV and VM. Methods:Fifty-six patients diagnosed as BPV and VM with vertigo were collected.and diagnosed as BPV and VM. Twenty cases were BPV and 36 cases were VM. The 40 controls were selected from healthy children. The screen of Child Anxiety Related Emotional Disorders and Depression Self-rating Scale for Children were done for total of children. The patients were received vestibular function test. Using SPSS17.0 software for statistical analysis, compared the difference of state with anxiety and depression in patients and controls. To analyze the psychological differences between BPV and VM. Results:All patients were among 8-17 (mean 10) years old, including 24 boys and 32 girls. Thirty-nine cases were school age and 17 cases were puberty. Vestibular function test was abnormal in 24 cases. Psychological abnormalities There were 30 cases suffered from psychological abnormalities. There were 26 cases with anxiety and 18 cases with depression, which 14 cases with comorbidity of anxiety and depression. Compared with the control group (19.88±6.72), the patients (24.75±15.71) showed statistically significant difference in anxiety (P<0.05), but no significant difference in depression. There was no statistical difference between BPV and VM in anxiety and depression. The possible risk factors of the two diseases were detected. There was statistically significant difference with the anxiety in adolescent and school age patients of VM(P<0.05). There was statistically significant difference with the anxiety in patients of BPV in gender (P<0.05). Conclusion:Children with vertigo are associated with negative emotions of anxiety and depression. There is no difference in psychological state between the children of BPV and VM. But adolescent and female children are more likely to have anxiety. Therefore, children with vertigo should pay attention to their mental and psychological state.


Assuntos
Depressão , Transtornos de Enxaqueca , Adolescente , Ansiedade/complicações , Vertigem Posicional Paroxística Benigna/complicações , Criança , Depressão/complicações , Tontura , Feminino , Humanos , Masculino , Transtornos de Enxaqueca/complicações
9.
Int J Mol Sci ; 22(14)2021 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-34299077

RESUMO

BACKGROUND: Depression is a common mood disorder during pregnancy impacting one in every seven women. Children exposed to prenatal depression are more likely to be born at a low birth weight and develop chronic diseases later in life. A proposed hypothesis for this relationship between early exposure to adversity and poor outcomes is accelerated aging. Telomere length has been used as a biomarker of cellular aging. We used high-resolution telomere length analysis to examine the relationship between placental telomere length distributions and maternal mood symptoms in pregnancy. METHODS: This study utilised samples from the longitudinal Grown in Wales (GiW) study. Women participating in this study were recruited at their presurgical appointment prior to a term elective caesarean section (ELCS). Women completed the Edinburgh Postnatal Depression Scale (EPDS) and trait subscale of the State-Trait Anxiety Inventory (STAI). Telomere length distributions were generated using single telomere length analysis (STELA) in 109 term placenta (37-42 weeks). Multiple linear regression was performed to examine the relationship between maternally reported symptoms of depression and anxiety at term and mean placental telomere length. RESULTS: Prenatal depression symptoms were significantly negatively associated with XpYp telomere length in female placenta (B = -0.098, p = 0.026, 95% CI -0.184, -0.012). There was no association between maternal depression symptoms and telomere length in male placenta (B = 0.022, p = 0.586, 95% CI -0.059, 0.103). There was no association with anxiety symptoms and telomere length for either sex. CONCLUSION: Maternal prenatal depression is associated with sex-specific differences in term placental telomeres. Telomere shortening in female placenta may indicate accelerated placental aging.


Assuntos
Transtornos de Ansiedade/complicações , Depressão/complicações , Placenta/patologia , Encurtamento do Telômero , Transtornos de Ansiedade/psicologia , Depressão/psicologia , Feminino , Idade Gestacional , Humanos , Lactente , Masculino , Idade Materna , Placenta/metabolismo , Gravidez , Fatores Sexuais
10.
Int J Mol Sci ; 22(11)2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34206086

RESUMO

Tuberculosis (TB) is an important infectious disease and a public health problem. The organs most frequently affected by TB are the lungs; despite this, it has been reported that TB patients suffer from depression and anxiety, which have been attributed to social factors. In previous experimental work, we observed that the extensive pulmonary inflammation characteristic of TB with high cytokine production induces neuroinflammation, neuronal death and behavioral abnormalities in the absence of brain infection. The objective of the present work was to reduce this neuroinflammation and avoid the psycho-affective disorders showed during pulmonary TB. Glucocorticoids (GCs) are the first-line treatment for neuroinflammation; however, their systemic administration generates various side effects, mostly aggravating pulmonary TB due to immunosuppression of cellular immunity. Intranasal administration is a route that allows drugs to be released directly in the brain through the olfactory nerve, reducing their doses and side effects. In the present work, dexamethasone's (DEX) intranasal administration was evaluated in TB BALB /c mice comparing three different doses (0.05, 0.25 and 2.5 mg/kg BW) on lung disease evolution, neuroinflammation and behavioral alterations. Low doses of dexamethasone significantly decreased neuroinflammation, improving behavioral status without aggravating lung disease.


Assuntos
Encéfalo/efeitos dos fármacos , Dexametasona/farmacologia , Inflamação/tratamento farmacológico , Tuberculose Pulmonar/tratamento farmacológico , Administração Intranasal , Animais , Ansiedade/complicações , Ansiedade/tratamento farmacológico , Ansiedade/patologia , Encéfalo/patologia , Depressão/complicações , Depressão/tratamento farmacológico , Depressão/patologia , Modelos Animais de Doenças , Glucocorticoides/farmacologia , Humanos , Inflamação/complicações , Inflamação/microbiologia , Inflamação/patologia , Camundongos , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/patogenicidade , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/patologia
12.
Gen Dent ; 69(4): 46-52, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34185668

RESUMO

Burning mouth syndrome (BMS) is a painful disorder characterized by severe burning in the oral cavity in the absence of clinical signs. In this case-control study, 60 patients were allocated to 3 groups: patients with BMS, patients with benign changes in the oral cavity (anxiety [positive] control group), or healthy patients (negative control group). A visual analog scale (VAS), Beck Anxiety and Depression inventories, Lipp Stress Symptoms Inventory, Xerostomia Inventory-Dutch Version, and a BMS questionnaire were used. Statistical analyses (P < 0.05) were performed using the Kruskal-Wallis with Dunn post hoc, Pearson chi-square, Fisher exact, and multinomial logistic regression tests. Most of the patients were female. The BMS group had more patients who were older than 60 years (P = 0.008), more patients with high VAS scores (P < 0.001), and more patients with moderate or severe anxiety (P < 0.001) and depression (P < 0.001) than the 2 control groups. Patients in the BMS group also had higher rates of stress during the alarm (P = 0.003), resistance (P < 0.001), and exhaustion phases (P < 0.001). All patients with BMS reported burning and xerostomia, 90% reported a feeling of dry mouth, and 80% reported a change in taste; these values were significantly higher than those in the control groups (P < 0.001). Anxiety was independently associated with a 123.80 times greater risk of having BMS (P = 0.004). Psychological factors are directly associated with BMS, and anxiety is the most important of these factor.


Assuntos
Síndrome da Ardência Bucal , Ansiedade/complicações , Transtornos de Ansiedade , Síndrome da Ardência Bucal/complicações , Síndrome da Ardência Bucal/epidemiologia , Estudos de Casos e Controles , Depressão/complicações , Depressão/epidemiologia , Feminino , Humanos
13.
Medicine (Baltimore) ; 100(24): e26035, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34128844

RESUMO

ABSTRACT: Acne is associated with depression and anxiety; however, the relationship between acne and suicide is still unclear. This study is aimed to evaluate the association between acne and suicide by conducting a meta-analysis. Studies were identified by electronic searches of the PubMed and EMBASE databases from their inception through Jan 10, 2020. Two authors separately assessed the quality and extracted data from the selected studies. When the heterogeneity was significant, we used a random-effects model to calculate overall pooled risk estimates.Five studies involving a total of 2,276,798 participants were finally included in the meta-analysis; 52,075 participants had acne. Suicide was positively associated with acne in the overall analysis (odds ratio (OR) 1.50, 95% confidence interval (95% CI): 1.09-2.06, P = .004, I2 = 74.1%). Subgroup analyses were performed for suicidal behavior groups (P = .002, I2 = 80.4%), suicidal ideation or thoughts groups (P = .849, I2 = 0.0%), International Classification of Diseases version 9 (ICD-9) groups (P = .137, I2 = 49.6%), non-ICD-9 groups (P = .950, I2 = 0.0%), American groups (P = .311, I2 = 2.4%), and non-American groups (P = .943, I2 = 0.0%). Sensitivity analyses indicated flawed results. No publication bias was detected.Acne may significantly increase suicide risk. Clinicians should actively treat acne and consider suicide screening. Further international studies with high-quality analyses are needed as more data are published.Ethical approval and patient consent are not required because this study is a literature-based study.


Assuntos
Acne Vulgar/psicologia , Ansiedade/epidemiologia , Depressão/epidemiologia , Suicídio/estatística & dados numéricos , Adolescente , Adulto , Ansiedade/complicações , Criança , Depressão/complicações , Feminino , Humanos , Masculino , Razão de Chances , Fatores de Risco , Suicídio/psicologia , Adulto Jovem
14.
Clin Interv Aging ; 16: 1105-1117, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34163154

RESUMO

Introduction: The aim of work is to assess the usefulness of oxidative stress parameters in the differential diagnosis of dementia of the Alzheimer's type and dementia of the Alzheimer's type with coexisting depression. Methods: The study involved three groups of people: patients with Alzheimer's disease (AD) (AD; N=27), patients with Alzheimer's disease and depression (D) (AD+D; N=30), and a control group that consisted of people without dementia and without depression (C; N=24). The assessment of cognitive functioning was carried out using among alia, Auditory Verbal Learning Test and Verbal Fluency Test. Furthermore, we determined the activity of superoxide dismutase (SOD-1) and superoxide anion radical. Results: Multiple models with different combinations of independent variables showed that SOD together with Rey delayed recall were the best significant predictors of AD with the area under curve (AUC) of 0.893 (p = 0.001) and superoxide anion radical (O2•-) together with verbal fluency - sharp objects were the best significant predictors of AD +D diagnosis with the AUC of 0.689 (p = 0.034). Conclusion: This study confirmed the value of neuropsychological diagnosis and analysis of oxidative stress markers in the diagnosis of AD and major depressive disorder (MDD) in the course of AD. The combination of the use of biochemical markers and neuropsychological tests seems particularly important for differential diagnosis.


Assuntos
Doença de Alzheimer/diagnóstico , Transtornos Cognitivos/diagnóstico , Depressão/diagnóstico , Estresse Oxidativo , Idoso , Doença de Alzheimer/complicações , Biomarcadores/análise , Estudos de Casos e Controles , Cognição , Transtornos Cognitivos/complicações , Depressão/complicações , Diagnóstico Diferencial , Humanos , Masculino , Rememoração Mental , Testes Neuropsicológicos , Índice de Gravidade de Doença
15.
Int J Mol Sci ; 22(9)2021 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-34068557

RESUMO

Depression is a prominent complex psychiatric disorder, usually complicated through expression of comorbid conditions, with chronic pain being among the most prevalent. This comorbidity is consistently associated with a poor prognosis and has been shown to negatively impact patient outcomes. With a global rise in this condition presenting itself, the importance of discovering long-term, effective, and affordable treatments is crucial. Electroacupuncture has demonstrated renowned success in its use for the treatment of pain and is a widely recognized therapy in clinical practice for the treatment of various psychosomatic disorders, most notably depression. Our study aimed to investigate the effects and mechanisms of Acid-Saline (AS) inducing states of chronic pain and depression comorbidity in the cerebellum, using the ST36 acupoint as the therapeutic intervention. Furthermore, the role of TRPV1 was relatedly explored through the use of TRPV1-/- mice (KO). The results indicated significant differences in the four behavioral tests used to characterize pain and depression states in mice. The AS and AS + SHAM group showed significant differences when compared to the Control and AS + EA groups in the von Frey and Hargreaves's tests, as well as the Open-Field and Forced Swimming tests. This evidence was further substantiated in the protein levels observed in immunoblotting, with significant differences between the AS and AS + SHAM groups when compared to the AS + EA and AS + KO groups being identified. In addition, immunofluorescence visibly served to corroborate the quantitative outcomes. Conclusively these findings suggest that AS-induced chronic pain and depression comorbidity elicits changes in the cerebellum lobules VI, VII, VIII, which are ameliorated through the use of EA at ST36 via its action on TRPV1 and related molecular pathways. The action of TRPV1 is not singular in CPDC, which would suggest other potential targets such as acid-sensing ion channel subtype 3 (ASIC3) or voltage-gated sodium channels (Navs) that could be explored in future studies.


Assuntos
Canais Iônicos Sensíveis a Ácido/genética , Dor Crônica/genética , Depressão/genética , Canais de Cátion TRPV/genética , Ácidos/toxicidade , Pontos de Acupuntura , Animais , Cerebelo/metabolismo , Cerebelo/patologia , Cerebelo/efeitos da radiação , Dor Crônica/induzido quimicamente , Dor Crônica/complicações , Dor Crônica/terapia , Comorbidade , Depressão/complicações , Depressão/patologia , Modelos Animais de Doenças , Eletroacupuntura , Humanos , Camundongos , Camundongos Knockout , Solução Salina/toxicidade , Natação
16.
Diabetes Res Clin Pract ; 176: 108863, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33992707

RESUMO

AIM: To assess the effect of depression on all-cause mortality in patients with type 2 diabetes mellitus (T2DM) followed up during 8 years in primary care in Spain. METHODS: Depression was diagnosed according to MINI 5.0.0 questionnaire, physician-diagnosis or following antidepressant therapy for at least two months in 3923 people with T2DM. We analyzed mortality-rates/10,000 person-years. We compared survival according to baseline depression with Kaplan-Meier estimates and the log-rank test. We performed Cox proportional hazard model analyses. RESULTS: Baseline depression was diagnosed in 22.1% of participants. Mortality was higher in patients with depression (31.9% vs. 26.9%; p = 0.003), who had a significantly poorer survival (median survival = 7.4 vs. 7.8 years, respectively; Log Rank = 15.83; p < 0.001). Depression showed an adjusted mortality hazard ratio (HR) = 1.40 (95%CI:1.20-1.65; p < 0.001). The strongest predictive factors were: age >75 years (HR = 6.04; 95%CI:4.62-7.91; p < 0.001), insulin use (HR = 2.37; 95%CI:1.86-3.00; p < 0.001), lower limb amputation (HR = 1.99; 95%CI:1.28-3.11; p = 0.002), heart failure (HR = 1.94; 95%CI:1.63-2.30; p < 0.001), and male gender (HR = 1.90; 95%CI:1.59-2.27). CONCLUSION: In a Spanish cohort of older T2DM patients, depression was associated with a higher mortality risk. More efforts are needed to minimize the influence of depression on mortality in people with T2DM and to implement measures that allow its early diagnosis and effective treatment.


Assuntos
Depressão/epidemiologia , Diabetes Mellitus Tipo 2/mortalidade , Diabetes Mellitus Tipo 2/psicologia , Idoso , Idoso de 80 Anos ou mais , Amputação/estatística & dados numéricos , Antidepressivos/uso terapêutico , Estudos de Coortes , Depressão/complicações , Depressão/tratamento farmacológico , Depressão/mortalidade , Diabetes Mellitus Tipo 2/complicações , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Mortalidade , Fatores de Risco , Espanha/epidemiologia , Análise de Sobrevida , Resultado do Tratamento
17.
J Psychosom Res ; 147: 110516, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34023580

RESUMO

BACKGROUND: Evidence from previous virus epidemics has shown that infected patients are at risk for developing psychiatric and mental health disorders, such as depression, anxiety, and insomnia. Hence, to collect high-quality data on the impact of COVID-19 pandemic on the prevalence of depression, anxiety, and insomnia symptoms among patients infected with SARS-CoV-2 should be the immediate priority. METHODS: A comprehensive search of Medline, Embase, Web of Science, and PsycINFO databases was conducted from January 1, 2020 to December 26, 2020 for eligible studies reporting on the prevalence of depression, anxiety, and insomnia symptoms in patients with COVID-19. Studies meeting the following criteria were included in the analysis: (1) included patients with COVD-19; (2) recorded the prevalence of depression, anxiety, or insomnia symptom; (3) sample size ≥30; (4) with validated screening tools; and (5) passed through the international peer-review process. Data extraction and quality assessment was independently performed by two reviewers. The quality effects meta-analysis was conducted further to calculate the pooled prevalence. RESULTS: Twenty-two studies were included for analysis with a total of 4318 patients. The pooled prevalence of depression, anxiety and insomnia symptoms was 38% (95% CI = 25-51), 38% (95% CI = 24-52), and 48% (95% CI = 11-85), respectively. Neither subgroup analysis nor sensitivity analysis can explain the source of high heterogeneity. In addition, the prevalence estimates of depression, anxiety and insomnia symptoms varied based on different screening tools. CONCLUSIONS: The present systematic review and meta-analysis suggest that depression, anxiety, and insomnia symptoms are prevalent in a considerable proportion of patients with COVID-19. Thus, early detection and properly intervention for mental illness in this population are of great significance. Additionally, the quality of included studies to date has been variable, and ongoing surveillance is essential.


Assuntos
Ansiedade/complicações , Ansiedade/epidemiologia , COVID-19/complicações , Depressão/complicações , Depressão/epidemiologia , Distúrbios do Início e da Manutenção do Sono/complicações , Distúrbios do Início e da Manutenção do Sono/epidemiologia , COVID-19/epidemiologia , COVID-19/psicologia , Humanos , Modelos Estatísticos , Prevalência
18.
Minerva Med ; 112(4): 456-466, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34056888

RESUMO

Current investigations in pre-symptomatic dementia have suggested that depressive mood, a treatable condition, may play an important role in the development of the disorder. However, whether depression in adulthood constitute a risk factor, or a prodrome of dementia remains unclear. A major implication in such dispute is the analytic framework used to identify putative risk factors. Indeed, if evaluated in the years immediately prior to dementia diagnosis the association between depression and dementia may reflect depressive symptoms as a prodrome of yet-undiagnosed dementia. Unfortunately, long term prospective cohort investigations, reaching back into the preclinical phase of dementia are sparse. Here, we have surveyed high-quality evidence (systematic reviews and meta-analyses) on the association between depressive symptoms and increased odds of dementia. Meta-analytic findings are also presented and discussed regarding depression as a prodromal stage of dementia, or a consequence of underlying neurodegenerative processes. Additionally, the potential confounding effect of several variables on the risk association between depression and dementia, an aspect hardly investigated, is discussed. While early onset late-life depression - defined as starting before 60 years of age - increases the odds of developing dementia in predisposed subjects, late-onset depression appears to be a prodrome and a clear accelerating factor for cognitive deterioration. Since it is increasingly important to consider the potential of preemptive approaches to decrease the impact of dementia, evidence on potentially effective preventive strategies targeting depression as a risk factor, and next steps in further research are presented as concluding remarks.


Assuntos
Demência/etiologia , Depressão/complicações , Sintomas Prodrômicos , Fatores Etários , Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/prevenção & controle , Demência/diagnóstico , Demência/epidemiologia , Demência/prevenção & controle , Depressão/epidemiologia , Depressão/psicologia , Progressão da Doença , Humanos , Metanálise como Assunto , Doenças Neurodegenerativas/complicações , Doenças Neurodegenerativas/psicologia , Fatores de Risco , Revisões Sistemáticas como Assunto
19.
Neurology ; 97(1): e23-e33, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-33931534

RESUMO

OBJECTIVE: To evaluate sleepiness and central hypersomnia in multiple sclerosis (MS)-associated fatigue, we performed long-term polysomnography in patients with MS and healthy controls. METHODS: Patients with MS and healthy controls completed questionnaires on sleep, fatigue, sleepiness, and depression. They underwent nocturnal polysomnography, multiple sleep latency tests, and bed rest 24-hour polysomnography. Patients were divided into 3 groups (fatigue and sleepiness, fatigue and no sleepiness, neither fatigue nor sleepiness). RESULTS: Among 44 patients with MS, 19 (43.2%) had fatigue and sleepiness, 15 (34%) had only fatigue, and 10 (22.7%) had neither fatigue nor sleepiness. Compared to 24 controls, patients with fatigue and sleepiness had higher REM sleep percentages (median [interquartile range] 20.5% [19.6-24.7] vs 18.1% [12.6-20.6]), lower arousal indexes (12.7 [7.5-17.0] vs 22.4 [14.3-34.4]), and shorter daytime mean sleep latencies (8.6 [6.3-14.3] vs 16.6 [12.6-19.5] min). Restless leg syndrome, periodic leg movements, and sleep apnea had similar frequencies between groups. Central hypersomnia was found in 10 (53%) patients with fatigue and sleepiness (narcolepsy type 2, n = 2), in 2 (13%) patients with fatigue only, and in 3 (30%) patients with neither fatigue nor sleepiness. Patients with central hypersomnia were younger and sleepier than those without hypersomnia, but had similar levels of fatigue, disability, depression, cognitive performance, and frequencies of the human leukocyte antigen DQB1*0602 genotype. The severity of fatigue increased with higher depression scores, higher sleepiness severity, and lower sleep efficacy. CONCLUSION: Central hypersomnias are frequent in MS when fatigue and sleepiness are present. Screening them through polysomnography studies is recommended.


Assuntos
Distúrbios do Sono por Sonolência Excessiva/etiologia , Fadiga/etiologia , Esclerose Múltipla/complicações , Polissonografia/métodos , Adulto , Envelhecimento , Cognição , Depressão/complicações , Avaliação da Deficiência , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Fadiga/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/epidemiologia , Pacientes Ambulatoriais , Desempenho Psicomotor , Descanso , Síndrome das Pernas Inquietas/complicações , Síndromes da Apneia do Sono/complicações , Latência do Sono , Fases do Sono , Sono REM
20.
Aging (Albany NY) ; 13(11): 15078-15099, 2021 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-34051074

RESUMO

Depression is a complex neuropsychiatric disease involved multiple targets and signaling pathways. Systems pharmacology studies could potentially present a comprehensive molecular mechanism to delineate the anti-depressant effect of emodin (EMO). In this study, we investigated the anti-depressant effects of EMO in the chronic unpredictable mild stress (CUMS) rat model of depression and gained insights into the underlying mechanisms using systems pharmacology and molecular simulation analysis. Forty-three potential targets of EMO for treatment of depression were obtained. GO biological process analysis suggested that the biological functions of these targets mainly involve the regulation of reactive oxygen species metabolic process, response to lipopolysaccharide, regulation of inflammatory response, etc. KEGG pathway enrichment analysis showed that the PI3K-Akt signaling pathway, insulin resistance, IL-17 signaling pathway were the most significantly enriched signaling pathways. The molecular docking analysis revealed that EMO might have a strong combination with ESR1, AKT1 and GSK3B. Immunohistochemical staining and Western blotting showed that 2 weeks' EMO treatment (80 mg/kg/day) reduced depression related microglial activation, neuroinflammation and altered PI3K-Akt signaling pathway. Our findings provide a systemic pharmacology basis for the anti-depressant effects of EMO.


Assuntos
Antidepressivos/farmacologia , Emodina/farmacologia , Animais , Antidepressivos/uso terapêutico , Comportamento Animal , Depressão/complicações , Depressão/tratamento farmacológico , Emodina/química , Emodina/uso terapêutico , Ontologia Genética , Genoma , Inflamação/patologia , Masculino , Microglia/patologia , Simulação de Acoplamento Molecular , Neurônios/metabolismo , Neurônios/patologia , Fosfatidilinositol 3-Quinases/metabolismo , Córtex Pré-Frontal/patologia , Mapeamento de Interação de Proteínas , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos Sprague-Dawley , Reprodutibilidade dos Testes , Transdução de Sinais , Estresse Psicológico/complicações , Estresse Psicológico/tratamento farmacológico
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