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1.
Medicine (Baltimore) ; 98(39): e16720, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574792

RESUMO

BACKGROUND: Although chronic fatigue syndrome (CFS) sometimes referred to as myalgic encephalomyelitis (ME) is a very challenging condition to treat, there is evidence that individual cognitive behavioral therapy (ICBT) can be effective for treatment and management of its symptoms. Furthermore, group cognitive behavioral therapy (GCBT) is emerging as promising treatment for the condition.The aim of the present study was to explore further the effectiveness of GCBT in a routine clinical setting and to investigate associated positive psychological effects related to GCBT. METHODS: In this pragmatic, non-randomized, controlled trial, 28 people acted as their own waiting list control by completing a range of measures 8 weeks prior to taking part in the GCBT. The intervention consisted of 8 consecutive weeks of 2.5-hour sessions. RESULTS: Repeated measures analysis of covariance revealed significant improvements in physical fatigue (F = 28.31, P < .01, effect size d = 0.52), mental fatigue (F = 7.72, P < .01, effect size d = 0.22), and depressive symptoms (Beck depression inventory-fast screen for medical individuals [BDI-FS]: F = 11.43, P < .01, effect size d = 0.30; hospital anxiety and depression scale [HADS-D]: F = 16.72, P < .01, effect size d = 0.38) compared with the waiting list. Improvements in quality of life (F = 7.56, P < .01, effect size d = 0.23), hope (F = 15.15, P < .01, effect size d = 0.36), and optimism (F = 8.17, P < .01, effect size d = 0.23) were also identified, but no change was reported for anxiety levels. Global outcome measures revealed that the majority of the individuals found the treatment beneficial and were satisfied with the results. CONCLUSION: GCBT is a beneficial and cost-effective treatment that individuals find amenable in routine clinical practice for CFS. Additionally we have described important effects emerged on positive psychological dimensions such as hope and optimism potentially enhancing the overall benefit.


Assuntos
Terapia Cognitivo-Comportamental , Síndrome de Fadiga Crônica/psicologia , Síndrome de Fadiga Crônica/terapia , Listas de Espera , Adulto , Ansiedade/complicações , Ansiedade/terapia , Depressão/complicações , Depressão/terapia , Síndrome de Fadiga Crônica/complicações , Feminino , Esperança , Humanos , Masculino , Pessoa de Meia-Idade , Otimismo , Qualidade de Vida
2.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 275-281, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31496159

RESUMO

OBJECTIVE: To investigate the clinical features and implication of restless legs syndrome (RLS) in ischemic stroke patients. METHODS: A total of 199 ischemic stroke patients were enrolled and assessed by polysomnography (PSG). RLS was identified according to criteria of International Restless Legs Syndrome Study Group. Epworth Sleepiness Scale (ESS), Mini-mental State Examination (MMSE) and Patient Health Questionnaire (PHQ-9) were used to evaluate the sleep quality, cognitive function and post-stroke depression, respectively. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the neurological function 3 months after stroke onset. Gender-and age-matched non-ischemic stroke patients with RLS (primary PLS) were selected as controls. RESULTS: Twenty-two cases of RLS were identified among 199 ischemic stroke patients (11.1%). Generalized linear model and logistic regression showed that low serum ferritin level (ß=-133.3 mg/L, 95%CI:-200.4--0.1, P<0.01), subcortical infarction (OR=4.05, 95%CI:1.15-14.18, P<0.05) and female (OR=2.54, 95%CI:1.04-6.23, P<0.05) were identified as the risk factors of RLS in ischemic stroke patients. Compared with ischemic stroke patients without RLS, ESS increased by 4.37 (95%CI:2.33-6.41, P<0.01), PHQ-9 increased by 2.17 (95%CI:0.39--3.94, P<0.05), and reduced NIHSS from the baseline deceased by 0.97 (95%CI:-1.79--0.15, P<0.05) in ischemic stroke patients with RLS. In addition, the incidence of moderate-severe depression increased (OR=4.27, 95%CI:1.40-13.10, P<0.05) in ischemic stroke patients with RLS. The index of periodic leg movements of sleep (PLMS) with arousal in ischemic stroke patients with RLS was significantly higher than that in patients with primary RLS (ß=12.85, 95%CI:2.04-23.67, P<0.05). CONCLUSIONS: RLS is common in ischemic stroke patients and has adverse influences on patients.


Assuntos
Isquemia Encefálica , Síndrome das Pernas Inquietas , Acidente Vascular Cerebral , Isquemia Encefálica/complicações , Isquemia Encefálica/patologia , Depressão/complicações , Feminino , Humanos , Masculino , Polissonografia , Síndrome das Pernas Inquietas/complicações , Síndrome das Pernas Inquietas/patologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/patologia
3.
J Cancer Res Clin Oncol ; 145(8): 2141-2148, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31278473

RESUMO

PURPOSE: Many cancer patients (PTS) suffer from somatic or non-somatic symptoms. Studies have shown positive effects of music intervention (MI) on aspects of quality of life or symptom management. METHODS: Since there are poor data available about patient's needs regarding the use of MI as an adjunct to cancer treatment, n = 548 tumor PTS were polled anonymously at the outpatient department of the University Hospital Mannheim Tumor Center using a self-designed questionnaire. Univariate and multivariate analyses were performed. RESULTS: 486 data sets were eligible for analysis. 240 of the PTS were male and median age was 63 years. 38% had metastatic disease. 81% (n = 386) were currently receiving anti-tumor treatment. The majority of the PTS stated to have somatic symptoms. However, some of the PTS reported non-somatic symptoms like anxiety, loneliness, and depression. N = 187 (40%) of the PTS reported interest in complementary MI. In the univariate and multivariate analyses, especially PTS with non-somatic complaints and PTS, actively playing or making music showed significantly more interest in complementary MI, hoping for a relaxing therapeutic effect. PTS who play instruments would prefer more active forms of MI. CONCLUSION: 40% of PTS reported interest in additional MI during cancer treatment. PTS with non-somatic symptoms as well as patients affine to music might benefit from the use of MI potentially reducing their symptom burden. The inconsistent and heterogeneous data from randomized trials underline the importance of systematic research approaches with more relevant and standardized endpoints.


Assuntos
Terapias Complementares/métodos , Musicoterapia , Música , Neoplasias/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/complicações , Ansiedade/epidemiologia , Ansiedade/psicologia , Ansiedade/terapia , Terapias Complementares/psicologia , Terapias Complementares/estatística & dados numéricos , Depressão/complicações , Depressão/epidemiologia , Depressão/psicologia , Depressão/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Música/psicologia , Neoplasias/epidemiologia , Neoplasias/patologia , Neoplasias/psicologia , Qualidade de Vida , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Estresse Psicológico/terapia , Inquéritos e Questionários , Adulto Jovem
4.
Rev Lat Am Enfermagem ; 27: e3155, 2019 Jul 18.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31340343

RESUMO

OBJECTIVE: to evaluate pain in people living with human immunodeficiency virus/acquired immunodeficiency syndrome and to relate it to sociodemographic and clinical factors, depressive symptoms and health-related quality of life. METHOD: descriptive, analytical, observational, cross-sectional and quantitative study. Three hundred and two (302) people assisted at a specialized care service participated in the study. Instruments were used to evaluate sociodemographic and clinical data, depressive symptoms, and health-related quality of life. Descriptive, bivariate analysis and multiple logistic regression were used. RESULTS: the incidence of pain of mild intensity was 59.27%, recurrent in the head, with interference in mood, mostly affecting females and individuals with no schooling/low schooling. Women were more likely to have moderate or severe pain. People aged 49 to 59 years had greater pain intensity than people aged 18 to 29 years. The variables depressive symptoms and pain were directly proportional. The higher the health-related quality of life and schooling, the lower was the possibility of presence of pain. CONCLUSION: presence of pain is of concern and has association with female sex, lack of schooling/low schooling, worse level of health-related quality of life and presence of depressive symptoms.


Assuntos
Síndrome de Imunodeficiência Adquirida/complicações , Depressão/complicações , Infecções por HIV/complicações , Medição da Dor/estatística & dados numéricos , Dor/etiologia , Qualidade de Vida , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Fatores Etários , Brasil/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Dor/psicologia , Prevalência , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
5.
Nord J Psychiatry ; 73(6): 340-348, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31259640

RESUMO

Purpose: This study examined a developmental model that links affect-regulation difficulties in childhood with three dimensions of alexithymia in adolescence (difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking) and substance use and depression in adulthood, while accounting for cumulative contextual risk in childhood, and testing potential gender moderation. Methods: Multiple group path analyses were conducted using data from the Northern Finland Birth Cohort 1986 (N = 6963). Analyses used data collected during prenatal/birth, childhood, adolescence, and young adulthood periods. Results: Our examination of early precursors for alexithymia indicated that the associations of affect-regulation problems in childhood with alexithymia were stronger for girls, potentially putting girls with affect-regulation difficulties in childhood at higher risk for developing alexithymia in adolescence. The associations of cumulative contextual risk in childhood with alexithymia, substance use disorder, and depression diagnosis in adulthood were significant for both girls and boys. Our findings in regard to substance use and depression disorders revealed that alexithymia in adolescence predicted depression diagnosis in adulthood, particularly due to a contribution from the alexithymia domain of 'difficulties identifying feelings.' However, none of the alexithymia domains was directly associated with substance use disorder in adulthood. Conclusions: Our study contributes to research that links alexithymia with difficulties in affect regulation and cumulative contextual risk in childhood, yielding findings that may be relevant for preventive interventions.


Assuntos
Sintomas Afetivos/complicações , Depressão/complicações , Transtorno Depressivo/complicações , Psicologia do Adolescente , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Adulto , Criança , Estudos de Coortes , Emoções , Feminino , Finlândia , Humanos , Masculino , Gravidez , Adulto Jovem
6.
Artigo em Russo | MEDLINE | ID: mdl-31317903

RESUMO

AIM: To study structural correlates of apathy in patients with late-life depression. MATERIAL AND METHODS: Thirty-five patients (≥60 y.o.) with late-onset depression and 22 age-matched healthy volunteers underwent high resolution brain MRI-scanning, and a comprehensive neuropsychiatric examination including HAM-D and the Apathy Scale. RESULTS AND CONCLUSION: A morphometric analysis showed that apathy was associated with atrophy of the lateral prefrontal cortex and reduced grey matter volume of the caudate nucleus on the right, and the nucleus accumbens on the left. Depression correlated with reduced thickness of the medial orbitofrontal cortex bilaterally, rostral anterior cingulate gyrus on the left, isthmus cingulate gyrus on the right, and larger surface area of the entorhinal cortex. Total grey matter volume, grey/white matter volumes of the cerebellum, and cortical thickness in temporal and occipital regions were negatively correlated with both apathy and depression severity. Thus, atrophy of basal ganglia and lateral prefrontal cortex, well known neuroanatomical correlates of apathy in different psychiatric and neurological conditions, characterized it in late-life depression too. This supports the idea of independent pathophysiology of apathetic syndrome.


Assuntos
Apatia , Depressão , Transtorno Depressivo , Substância Branca , Encéfalo/diagnóstico por imagem , Depressão/complicações , Depressão/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/psicologia , Giro do Cíngulo , Humanos , Imagem por Ressonância Magnética
7.
Medicine (Baltimore) ; 98(26): e16268, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261597

RESUMO

The aim of the present study was to evaluate the risk of hip fracture in depression patients using a nationwide cohort population.Data from the Korean National Health Insurance Service-National Sample Cohort for a population ≥50 years of age from 2002 to 2013 were collected. The 25,197 individuals with depression were matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia, with 100,788 individuals comprising the control group. In both the depression and control groups, history of hip fracture was evaluated. Using the International Classification of Disease-10 (ICD-10) codes, depression (F31-F39), and hip fracture (S720, S721, and S722) were investigated. The crude and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of hip fracture in depression patients were analyzed using a Cox proportional hazard model. Subgroup analyses were conducted according to age and sex.In the depression group, 1.1% (277/25,197) of the subjects had hip fracture, and 0.7% (693/100,095) in the control group had hip fracture (P <.001). The depression group demonstrated a higher adjusted HR for hip fracture than the control group (adjusted HR = 1.46, 95% CI = 1.27-1.68, P <.001). This result was consistent in the ≥65 years old subgroups.The risk of hip fracture was elevated in depression patients.


Assuntos
Depressão/complicações , Fraturas do Quadril/complicações , Fraturas do Quadril/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , República da Coreia , Medição de Risco
8.
Z Psychosom Med Psychother ; 65(2): 198, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31154929

RESUMO

Long-term effectiveness of psychodynamic inpatient therapy on depressive disorders - Catamnestic- Results of the STOP-D-Study Objectives: Depression is one of the most common disorders with a rate of recurrence between 60-75 %. The effectiveness of psychodynamic therapy is well-proven, but there is still a lack of studies proving the long-term effectiveness of inpatient treatment on depressive symptom load. Methods: After psychodynamic inpatient treatment in a psychodynamically oriented psychosomatic hospital unit, the reduction in general and depressive symptom load (e. g. BDI, HAMD, SCL-90-R) was evaluated by a six-month follow up design. The study was set up as naturalistic multicenter intervention study including a female follow-up sample (N = 291; age 25-45 years). Results: The symptom improvement reached by the inpatient treatment remained stable at the follow-up survey. Patients treated with antidepressant medication showed stronger depressive symptom load at discharge and follow-up survey compared to patients without antidepressant medication. Sociodemographic variables and a comorbid personality disorder were not associated with increased drop-out rates, but depressive symptom load and a premature ending of the treatment. Conclusions: The obtained results demonstrate the long-term effectiveness of inpatient psychodynamic psychotherapy. Further studies about the influence of post-hospital psychotherapy and medical treatment as well as patient satisfaction seem necessary.


Assuntos
Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Pacientes Internados/psicologia , Psicoterapia Psicodinâmica , Adulto , Depressão/complicações , Depressão/psicologia , Depressão/terapia , Transtorno Depressivo/complicações , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/complicações , Fatores de Tempo , Resultado do Tratamento
9.
Z Psychosom Med Psychother ; 65(2): 183-197, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31154931

RESUMO

Objectives: There is an ongoing debate as to whether job burnout and depression are overlapping concepts or differ from each other, although this has not been scrutinized in inpatients. To further elucidate the robustness of this relationship, we used three different measurements of depression. We further examined the influence of psychological distress, perceived stress and sleep quality in the link between depressive symptoms and burnout. Methods: We investigated 723 consecutive inpatients, aged 23 to 82 years, 51.2 % women, referred to a hospital specialized in the treatment of job stress-related disorders. Patients completed the Maslach Burnout Inventory, the Beck Depression Inventory, the Hospital Anxiety and Depression Scale, the Brief Symptom Inventory, the Perceived Stress Scale, and the Pittsburgh Sleep Quality Index. Results: We found significant correlations between burnout total scores as well as subscales (emotional exhaustion, depersonalization, lack of accomplishment) and depressive symptoms, virtually independent of the applied depression measure. The shared variance ranged between 1.1 % and 19.4 %. Greater levels of burnout were directly associated with cognitiveaffective symptoms and, although to a lesser extent, also with somatic-affective symptoms of depression. In the multivariable analysis, significantly more total burnout symptoms were revealed in more depressed and younger patients, in men than women, and in employees with greater levels of psychological distress and perceived stress, respectively. Conclusions: The findings suggest that although burnout and depression do not represent the same psychopathology, there is considerable overlap between the two constructs; the extent of this overlap may vary depending upon the applied depression measure.


Assuntos
Esgotamento Profissional/terapia , Depressão/psicologia , Pacientes Internados , Estresse Ocupacional/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Esgotamento Profissional/complicações , Esgotamento Profissional/diagnóstico , Esgotamento Profissional/psicologia , Depressão/complicações , Depressão/diagnóstico , Feminino , Humanos , Pacientes Internados/psicologia , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/complicações , Estresse Ocupacional/diagnóstico , Estresse Ocupacional/psicologia , Psicopatologia , Adulto Jovem
10.
Oncology ; 97(4): 245-253, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31163421

RESUMO

PURPOSE: Quality of sleep (QoS), anxiety, depression, and quality of life (QoL) are common issues among breast cancer patients. Prospective longitudinal studies of QoS, anxiety, depression, and QoL in breast cancer patients are lacking. The aim of this study was to find out whether there is a proper treatment point associated with QoS, anxiety, depression, and QoL during early treatment of breast cancer patients. METHODS: We used 4 self-report questionnaires about QoS, anxiety, depression, and QoL. QoS was measured using the Pittsburgh Sleep Quality Index, anxiety was measured with the Beck Anxiety Inventory, depression was measured with the Beck Depression Inventory, and QoL was measured with the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form. Patients were assessed at the time of surgery, at the beginning of chemotherapy, and at the end of chemotherapy. Clinicopathological information was collected for analysis. RESULTS: Fifty-two patients were enrolled in this study, and 29 completed 3 self-report questionnaires. QoS, anxiety, and depression showed no differences during the early treatment period. However, QoL changed during that period (p = 0.004). Type of breast surgery (total mastectomy vs. breast-conserving surgery) showed a relationship with QoS during the entire treatment period, but with anxiety only at the time of surgery (p = 0.002). Although the sample size was too small, the total mastectomy group showed better results. CONCLUSION: Breast cancer patients experience sleep disturbance, anxiety, depression, and loss of QoL. During the period of treatment, these do not change significantly, but these symptoms are often overlooked. Providing sufficient explanations about the treatment and prognosis of breast cancer and mental support for breast cancer patients prior to treatment will help to improve patients' QoS, anxiety, depression, and QoL.


Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/psicologia , Sono , Adulto , Idoso , Antineoplásicos/efeitos adversos , Ansiedade/complicações , Neoplasias da Mama/tratamento farmacológico , Depressão/complicações , Feminino , Humanos , Estudos Longitudinais , Mastectomia , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Psicometria , Qualidade de Vida , Autorrelato , Índice de Gravidade de Doença , Inquéritos e Questionários
11.
Nervenarzt ; 90(9): 961-974, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31172233

RESUMO

The prevalence rates of psychiatric disorders show a high risk for psychological impairment among physicians in Germany. There is evidence that the mental health of physicians exerts a significant influence on the quality of patient care. The estimated prevalence rates for burnout among physicians in Germany vary between 4% and 20% and for depression between 6% and 13%. In addition, there is evidence for impairment in the context of anxiety, suicidal tendencies and substance abuse. Importantly, work-related stress factors play an important role in the development of mental disorders among physicians. In addition to individual prevention and interventions, institutional measures have been shown to be effective as a preventive strategy. It is therefore important to establish effective interventions specifically tailored to physicians to reduce stress factors at work.


Assuntos
Ansiedade , Esgotamento Profissional , Depressão , Saúde Mental , Médicos/psicologia , Médicos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias , Ansiedade/complicações , Esgotamento Profissional/complicações , Depressão/complicações , Alemanha , Humanos , Saúde Mental/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/complicações
12.
Artigo em Chinês | MEDLINE | ID: mdl-31163548

RESUMO

Objective: To investigate the psychological status of anxiety and depression in patients with idiopathic tinnitus, and to analyze its relative factors. Method: One hundred and sixty seven patients with idiopathic tinnitus were assessed by Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS) and general condition questionnaire. Patients with anxiety or depression were reassessed after corresponding treatment for 6 weeks. Result: Fifty-five patients(32.93%) were in anxiety state and 43 patients(25.75%) were in depression state. Twenty-seven patients(16.17%) were in both anxiety and depression state. The multivariate logistic regression analysis found that the incidence of anxiety and depression in patients with idiopathic tinnitus were related to sleep disorders, course of disease and THI score(P<0.05). Treatment scores(SAS and SDS) were statistically significantly different between pre- and post-treatment(P<0.01). Conclusion: The anxiety and depression state is highly prevalent in idiopathic tinnitus patients and is related to course of disease, severity of tinnitus and sleep disorders. In clinical practice, we should pay close attention to the psychological status of patients with idiopathic tinnitus, and take timely psychological intervention.


Assuntos
Ansiedade/complicações , Depressão/complicações , Zumbido/complicações , Zumbido/psicologia , Humanos , Inquéritos e Questionários
13.
Rev. neurol. (Ed. impr.) ; 68(12): 493-502, 16 jun., 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-180476

RESUMO

Objetivo. Realizar un metaanálisis de estudios de cohortes prospectivos, con base poblacional, que investiguen el riesgo de demencia y enfermedad de Alzheimer (EA) según la depresión clínicamente relevante, diagnosticada con criterios del Geriatric Mental State (GMS). Pacientes y métodos. Se realizó una búsqueda sistemática de los estudios publicados en PubMed y Web of Science hasta enero de 2018 para identificar todos los estudios longitudinales sobre la asociación entre la depresión clínicamente relevante (diagnosticada con criterios del GMS) y el riesgo de demencia y EA en los ancianos. Se calculó el riesgo relativo agrupado para examinar la depresión como un posible factor de riesgo para la demencia en estudios comunitarios, así como la fracción poblacional de demencia y EA atribuible a la depresión. Resultados. Seis estudios cumplieron los criterios de inclusión para la revisión sistemática. Todos ellos proporcionaron suficiente información para realizar un metaanálisis. Los participantes con depresión clínicamente relevante tuvieron un riesgo un 54% más elevado de demencia (p = 0,026) y una fracción atribuible poblacional del 8,6%. Los pacientes con EA tuvieron un riesgo un 50% más alto (p = 0,038) y una fracción atribuible poblacional del 10,8%. Conclusión. La depresión clínicamente relevante se asocia con un mayor riesgo de demencia y EA en la comunidad, con un impacto potencial mayor que otros factores de riesgo conocidos. Los estudios futuros deben explorar los mecanismos que vinculan la depresión con la demencia y la EA, así como si un tratamiento eficaz de la depresión clínicamente relevante podría prevenir la demencia y el desarrollo de la EA


Aim. To carry out a meta-analysis of population-based prospective cohort studies to investigate the risk of dementia and Alzheimer's disease (AD) according to clinically relevant depression, assessed with Geriatric Mental State (GMS) criteria. Patients and methods. A systematic literature search of the studies published in PubMed and Web of Science up to January 2018 was performed to identify all longitudinal studies on the association between clinically relevant depression (diagnosed with GMS criteria) and risk of dementia in the elderly. We calculated pooled relative risks to examine depression as a possible risk factor for dementia in community studies, as well as to compute population attributable fraction (PAF). Results. Six studies met inclusion criteria for the systematic review. All of them provided enough information to perform a meta-analysis. Participants with clinically relevant depression had a 54% higher risk of dementia (p = 0.026) with a PAF attributable to clinically relevant depression of 8.6%. The numbers for AD were 50% higher risk (p = 0.038) and a PAF of 10.8%. Conclusion. Clinically relevant depression is associated with an increased risk for dementia and AD in the community, with a potential impact higher than other known/recognized risk factors. Future studies should explore the mechanisms linking depression and dementia and AD as well as whether an effective treatment of clinically significant depression could prevent dementia and AD development


Assuntos
Humanos , Depressão/complicações , Demência/etiologia , Doença de Alzheimer/etiologia , Fatores de Risco , Estudos Prospectivos , Fatores de Tempo
15.
Gastroenterology ; 157(2): 507-521.e4, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31071306

RESUMO

BACKGROUND & AIMS: Mood disorders and constipation are often comorbid, yet their shared etiologies have rarely been explored. The neurotransmitter serotonin (5-HT) regulates central nervous system and enteric nervous system (ENS) development and long-term functions, including gastrointestinal (GI) motility and mood. Therefore, defects in neuron production of 5-HT might result in brain and intestinal dysfunction. Tryptophan hydroxylase 2 (TPH2) is the rate-limiting enzyme in 5-HT biosynthesis. A variant of TPH2 that encodes the R441H substitution (TPH2-R441H) was identified in individuals with severe depression. We studied mice with an analogous mutation (TPH2-R439H), which results in a 60%-80% decrease in levels of 5-HT in the central nervous system and behaviors associated with depression in humans. Feeding chow that contains 5-HTP slow release (5-HTP SR) to TPH2-R439H mice restores levels of 5-HT in the central nervous system and reduces depressive-like behaviors. METHODS: We compared the effects of feeding chow, with or without 5-HTP SR, to mice with the TPH2-R439H mutation and without this mutation (control mice). Myenteric and submucosal plexuses were isolated from all 4 groups of mice, and immunocytochemistry was used to quantify total enteric neurons, serotonergic neurons, and 5-HT-dependent subsets of neurons. We performed calcium imaging experiments to evaluate responses of enteric neurons to tryptamine-evoked release of endogenous 5-HT. In live mice, we measured total GI transit, gastric emptying, small intestinal transit, and propulsive colorectal motility. To measure colonic migrating motor complexes (CMMCs), we isolated colons and constructed spatiotemporal maps along the proximodistal length to quantify the frequency, velocity, and length of CMMCs. We measured villus height, crypt perimeter, and relative densities of enterochromaffin and enteroendocrine cells in small intestinal tissue. RESULTS: Levels of 5-HT were significantly lower in enteric neurons from TPH2-R439H mice than from control mice. TPH2-R439H mice had abnormalities in ENS development and ENS-mediated GI functions, including reduced motility and intestinal epithelial growth. Total GI transit and propulsive colorectal motility were slower in TPH2-R439H mice than controls, and CMMCs were slower and less frequent. Villus height and crypt perimeter were significantly decreased in colon tissues from TPH2-R439H mice compared with controls. Administration of 5-HTP SR to adult TPH2-R439H mice restored 5-HT to enteric neurons and reversed these abnormalities. Adult TPH2-R439H mice given oral 5-HTP SR had normalized numbers of enteric neurons, total GI transit, and colonic motility. Intestinal tissue from these mice had normal measures of CMMCs and enteric epithelial growth CONCLUSIONS: In studies of TPH2-R439H mice, we found evidence for reduced release of 5-HT from enteric neurons that results in defects in ENS development and GI motility. Our findings indicate that neuron production of 5-HT links constipation with mood dysfunction. Administration of 5-HTP SR to mice restored 5-HT to the ENS and normalized GI motility and growth of the enteric epithelium. 5-HTP SR might be used to treat patients with intestinal dysfunction associated with low levels of 5-HT.


Assuntos
5-Hidroxitriptofano/administração & dosagem , Constipação Intestinal/tratamento farmacológico , Depressão/tratamento farmacológico , Trato Gastrointestinal/fisiopatologia , Serotonina/metabolismo , Animais , Constipação Intestinal/etiologia , Constipação Intestinal/fisiopatologia , Preparações de Ação Retardada/administração & dosagem , Depressão/complicações , Depressão/genética , Depressão/fisiopatologia , Modelos Animais de Doenças , Sistema Nervoso Entérico/efeitos dos fármacos , Sistema Nervoso Entérico/fisiopatologia , Feminino , Motilidade Gastrointestinal/efeitos dos fármacos , Motilidade Gastrointestinal/fisiologia , Trato Gastrointestinal/efeitos dos fármacos , Trato Gastrointestinal/inervação , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Mutação , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Resultado do Tratamento , Triptofano Hidroxilase/genética , Triptofano Hidroxilase/metabolismo
16.
Medicine (Baltimore) ; 98(19): e15564, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083224

RESUMO

Depression is one of the most common mental health problems which affects more than 10% of the global population. The prevalence of this disorder is higher in fibromyalgia patients. However, the influence of the combination of depression and fibromyalgia in the brain processing is poorly understood.To explore the modifications of EEG power spectrum in women with fibromyalgia when depressive feelings are elicited.Twenty eight women with fibromyalgia participated in this cross-sectional study. They were classified as women with depression or women without depression according to the score in the Geriatric Depression Scale. This questionnaire was used to elicit depression symptoms during the EEG recording. Analyses were performed with the standardized LOw Resolution Electric Tomography (sLORETA) software. Power spectrum were compared in the following frequency bands: delta, theta, alpha-1, alpha-2, beta-1, beta-2, and beta-3.Fibromyalgia patients with untreated depression showed a hypoactivation of the left hemisphere when compared with fibromyalgia patients without depression. In addition, when compared fibromyalgia patients without depression and women with both fibromyalgia and depression who were taking antidepressant medications, differences in EEG power spectrum in the studied frequency bands were not found.The current study contributes to the understanding on the influence of the combination of fibromyalgia and depression in the brain activity patterns. Patients with untreated depression showed a hypoactivation of the left hemisphere while eliciting depression symptoms. However, further research is needed, antidepressant medication might reduce the differences between patients with depression and those who do not suffer from depression symptoms.


Assuntos
Encéfalo/fisiopatologia , Depressão/fisiopatologia , Transtorno Depressivo/complicações , Transtorno Depressivo/fisiopatologia , Fibromialgia/fisiopatologia , Fibromialgia/psicologia , Antidepressivos/uso terapêutico , Estudos Transversais , Depressão/complicações , Transtorno Depressivo/tratamento farmacológico , Eletroencefalografia , Feminino , Fibromialgia/complicações , Humanos , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica
17.
Wiad Lek ; 72(4): 635-638, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31055547

RESUMO

OBJECTIVE: Introduction: The association of chronic obstructive pulmonary disease and pulmonary tuberculosis is an important medical and social problem with a significant burden in terms of morbidity and mortality. The course and prognosis of chronic diseases such as chronic obstructive pulmonary disease and pulmonary tuberculosis is greatly influenced not only by the clinical features but also by the psychological characteristics of the patient. The aim: To study the interaction between clinical changes and psychological characteristics considering gender differences among patients with chronic obstructive pulmonary disease in association with pulmonary tuberculosis. PATIENTS AND METHODS: Materials and methods: We studied 41patients with chronic obstructive pulmonary disease (grade 2, 3, groups А, B, С, D) and infiltrative pulmonary tuberculosis co-morbidity (11 women and 30 men). All patients underwent general clinical examination, Acid-Fast Bacillus Testing, spirometry, Spielberg anxiety scale, Beck depression scale. RESULTS: Results: Patients with chronic obstructive pulmonary disease and pulmonary tuberculosis co-morbidity with more severe symptoms (according to Assesment Test scores) were older and, regardless of it, showed elevated depression and personal anxiety scores while situational anxiety scores were significantly lower compared to those with less severe symptoms. The correlation between symptoms severity and airflow limitation or smoking history was very mild. The elevated depression and personal anxiety could cause more severe symptoms. The revealed discrepancy between the symptoms severity and low levels of situational anxiety may be due to adaptation with displacement mechanisms to illness related chronic life stressors. We also observed elevated personal anxiety and depression scores together with less severe symptoms among female versus male chronic obstructive pulmonary disease/pulmonary tuberculosis patients, possibly reflecting physically ill women's higher risk for depressive and anxiety related symptomatology relative to ill men. CONCLUSION: Conclusions: We revealed that among patients with chronic obstructive pulmonary disease and pulmonary tuberculosis co-morbidity symptoms severity was largely influenced by the patients' age, gender and psychological factors (depression and personal anxiety), but, unexpectedly, much less - by airflow limitation and smoking history. We also found higher emotional distress, namely elevated personal anxiety and depression scores, in combination with less severe symptoms among female versus male patients with chronic obstructive pulmonary disease and pulmonary tuberculosis co-morbidity.


Assuntos
Ansiedade/complicações , Depressão/complicações , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/psicologia , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/psicologia , Comorbidade , Feminino , Humanos , Masculino , Qualidade de Vida , Índice de Gravidade de Doença
18.
J Clin Nurs ; 28(15-16): 2782-2789, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31067340

RESUMO

AIMS AND OBJECTIVES: To identify whether meaning in life has moderating and mediating effects on the relationship between depression and quality of life in patients with dysphagia. BACKGROUND: Dysphagic patients typically have multidimensional problems, such as depression, which can negatively influence their quality of life. Meaning in life, therefore, can be used as a psychological resource that may enhance quality of life for these patients. DESIGN: A descriptive cross-sectional research design was used. METHODS: Ninety patients with dysphagia were recruited for a survey from eight general and rehabilitation hospitals in Korea. The questionnaires, which included the Korean version of the Swallowing Quality of Life scale developed by Cha, the Center for Epidemiological Studies-Depression Scale developed by Radloff, and the Purpose in Life test developed by Crumbaugh and Maholick, were used for data collection. Descriptive statistics, Hayes' PROCESS macro and Cronbach's alpha were used for data analyses. RESULTS: Meaning in life was found to mediate the relationship between depression and quality of life in patients with dysphagia. However, the index of moderation was not statistically significant, which mean that meaning in life did not moderate the relationship between the patients' depression and quality of life. CONCLUSIONS: Meaning in life had a mediating effect on the relationship between depression and quality of life in patients with dysphagia. Thus, to improve the quality of life of patients with dysphagia, nurses should apply interventions to help them find meaning in life. RELEVANCE TO CLINICAL PRACTICE: Meaning in life can be used as a nursing intervention strategy to improve the quality of life for patients living with dysphagia and depression.


Assuntos
Transtornos de Deglutição/psicologia , Depressão/psicologia , Qualidade de Vida , Estudos Transversais , Transtornos de Deglutição/complicações , Transtornos de Deglutição/enfermagem , Depressão/complicações , Depressão/enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Inquéritos e Questionários , Traduções
19.
Work ; 62(4): 599-613, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31104044

RESUMO

BACKGROUND: Workplace mental health disability claims are rising with concomitant challenges to return-to-work (RTW) success. Cognitive work hardening (CWH) addresses work re-entry issues including fatigue, coping skills, and reduced cognitive abilities which are relevant for people returning to work following an episode of depression. OBJECTIVE: To gain insight into underlying factors contributing to CWH's effectiveness in RTW preparation following depression. METHODS: Twenty-one individuals on paid disability leave due to depression completed a four week CWH treatment intervention prior to returning to work. At program completion and at three months follow up, participants provided qualitative information regarding their experience of the intervention in the form of written questionnaires and interviews. Data were analyzed using a directed approach to content analysis. RESULTS: Intervention elements perceived by participants as helpful included structure, work simulations, and simulated work environment. Main treatment gains reported by participants related to routine, self-confidence, stamina, and cognitive abilities. Personal agency, empowerment, and skill development emerged as important consequences of interventions for RTW following depression. CONCLUSIONS: Study findings enhance understanding of CWH with relevance to clinical practice. Key intervention elements deemed important for RTW are discussed and may provide guidance for other work-re-entry programs.


Assuntos
Adaptação Psicológica , Depressão/psicologia , Retorno ao Trabalho/psicologia , Adulto , Depressão/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Ocupacional/métodos , Terapia Ocupacional/tendências , Ontário , Pesquisa Qualitativa , Retorno ao Trabalho/tendências , Inquéritos e Questionários , Local de Trabalho/psicologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-30995366

RESUMO

Objective: Orthostatic intolerance (OI) is an important health problem for children and adolescents. The onset and exacerbation of OI are strongly affected by psychosocial factors. Intestinal microbial deviations, which are affected by food and lifestyle factors, are an important risk factor for adult psychiatry patients, but their roles in pediatric patients are unclear. The objective of this study was to investigate the intestinal microbiota and its involvement in the mental health of children with OI. Methods: Fifty-six fecal samples from pediatric OI patients and 9 samples from healthy children were examined with terminal-restriction fragment length polymorphism analysis from July 2016 to January 2018 at Nihon University Itabashi Hospital, Tokyo, Japan. Bacterial diversity was analyzed using the Shannon-Wiener index and the Simpson index. All OI patients were assessed using 2 different psychological scales: the Children's Depression Inventory and the Children's Manifest Anxiety Scale. The patients were then divided into the following subgroups: depression or nondepression and anxiety or nonanxiety. Results: The mean proportion of Clostridium subcluster XIVa and/or Enterobacteriaceae (operational taxonomic unit [OTU] 940) in the OI patients was significantly higher than that in the healthy controls (P = .02). Among OI patients, Bifidobacterium (OTU 124) was less frequent in the depression group than in the nondepression group. However, depression and anxiety showed no correlation with bacterial diversity. Conclusions: Pediatric OI patients showed deviations in the intestinal bacterial flora. The intestinal flora can serve as a novel therapeutic target for the mental health management of intractable pediatric OI patients.


Assuntos
Ansiedade/microbiologia , Depressão/microbiologia , Fezes/microbiologia , Microbioma Gastrointestinal , Intolerância Ortostática/microbiologia , Adolescente , Ansiedade/complicações , Criança , Depressão/complicações , Feminino , Humanos , Masculino , Intolerância Ortostática/complicações
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