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1.
PLoS One ; 15(11): e0241895, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33175894

RESUMO

Despite the profound health and economic implications of Covid-19, there is only limited knowledge to date about the role of economic concerns, health worries and social distancing for mental health outcomes during the pandemic. We analyze online survey data from the nationally representative "Understanding America Study" (UAS) covering the period of March 10-31st 2020 (sample size: 6,585). Mental health is assessed by the validated PHQ-4 instrument for measuring symptoms of depression and anxiety. About 29% (CI:27.4-.30.4%) of the US adult population reported some depression/anxiety symptoms over the study period, with symptoms deteriorating over the month of March. Worsening mental health was most strongly associated with concerns about the economic consequences of the pandemic, while concerns about the potential implications of the virus for respondents' own health and social distancing also predicted increases in symptoms of depression and anxiety during the early stages of the pandemic in the US, albeit less strongly. Our findings point towards the possibility of a major mental health crisis unfolding simultaneously with the pandemic, with economic concerns being a key driving force of this crisis. These results highlight the likely importance of economic countermeasures and social policy for mitigating the impact of Covid-19 on adult mental health in the US over and above an effective public health response.


Assuntos
Infecções por Coronavirus/patologia , Status Econômico , Saúde Mental , Pneumonia Viral/patologia , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Risco , Inquéritos e Questionários , Estados Unidos/epidemiologia
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 120-123, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33017945

RESUMO

A two-stage deep learning-based scheme is presented to predict the Hamilton Depression Scale (HAM-D) in this study. First, the cross-sample entropy (CSE) that allows assessing the degree of similarity of two data series are evaluated for the 90 brain regions of interest partitioned according to Automated Anatomical Labeling. The obtained CSE maps are then converted to 3D CSE volumes to serve as the inputs to the deep learning network models for the HAM-D scale level classification and prediction. The efficacy of the proposed scheme was illustrated by the resting-state functional magnetic resonance imaging data from 38 patients. From the results, the root mean square errors for the HAM-D scale prediction obtained during training, validation, and testing were 2.73, 2.66, and 2.18, which were less than those of a scheme having only a regression stage.


Assuntos
Aprendizado Profundo , Depressão , Encéfalo , Depressão/diagnóstico , Entropia , Humanos , Imagem por Ressonância Magnética
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 128-133, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33017947

RESUMO

Electroencephalography (EEG)-based depression detection has become a hot topic in the development of biomedical engineering. However, the complexity and nonstationarity of EEG signals are two biggest obstacles to this application. In addition, the generalization of detection algorithms may be degraded owing to the influences brought by individual differences. In view of the correlation between EEG signals and individual demographics, such as gender, age, etc., and influences of these demographic factors on the incidence of depression, it would be better to incorporate demographic factors during EEG modeling and depression detection. In this work, we constructed an one-dimensional Convolutional Neural Network (1-D CNN) to obtain more effective features of EEG signals, then integrated gender and age factors into the 1-D CNN via an attention mechanism, which could prompt our 1-D CNN to explore complex correlations between EEG signals and demographic factors, and generate more effective high-level representations ultimately for the detection of depression. Experimental results on 170 (81 depressed patients and 89 normal controls) subjects showed that the proposed method is superior to the unitary 1-D CNN without gender and age factors and two other ways of incorporating demographics. This work also indicates that organic mixture of EEG signals and demographic factors is promising for the detection of depression.Clinical relevance-This work indicates that organically mixture of EEG signals and demographic factors is promising for the detection of depression.


Assuntos
Depressão , Redes Neurais de Computação , Atenção , Demografia , Depressão/diagnóstico , Eletroencefalografia , Humanos
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3707-3710, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018806

RESUMO

There is a recent interest in finding neurophysiological biomarkers which will facilitate the diagnosis and understanding of the neural basis of different psychiatric disorders. In this paper, we evaluated the resting-state global EEG connectivity as a potential biomarker for depressive and anxiety symptoms. For this, we evaluated a population of 119 subjects, including 75 healthy subjects and 44 patients with major depressive disorder. We calculated the global connectivity (spectral coherence) in a setup of 60 EEG channels, for six different spectral bands: theta, alpha1, alpha2, beta1, beta2, and gamma. These global connectivity scores were used to train a Support Vector Regressor to predict symptoms measured by the Beck Depression Inventory (BDI) and the Spielberger Trait Anxiety Inventory (TAI). Experiments showed a significant prediction of both symptoms, with a mean absolute error (MAE) of 8.07±6.98 and 11.52±8.7 points, respectively. Among the most discriminating features, the global connectivity in the alpha2 band (10.0-12.0Hz) presented significantly positive Spearman's correlation with the depressive (rho = 0.32, pFDR <0.01), and the anxiety symptoms (rho = 0.26, pFDR<0.01).Clinical relevance-This study demonstrates that EEG global connectivity can be used to predict depression and anxiety symptoms measured by widely used questionnaires.


Assuntos
Transtorno Depressivo Maior , Ansiedade/diagnóstico , Transtornos de Ansiedade/diagnóstico , Depressão/diagnóstico , Eletroencefalografia , Humanos
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5490-5493, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019222

RESUMO

Depression is both debilitating and prevalent. While treatable, it is often undiagnosed. Passive depression screening is crucial, but leveraging data from Smartphones and social media has privacy concerns. Inspired by the known relationship between depression and slower information processing speed, we hypothesize the latency of texting replies will contain useful information in screening for depression. Specifically, we extract nine reply latency related features from crowd-sourced text message conversation meta-data. By considering text metadata instead of content, we mitigate the privacy concerns. To predict binary screening survey scores, we explore a variety of machine learning methods built on principal components of the latency features. Our findings demonstrate that an XGBoost model built with one principal component achieves an F1 score of 0.67, AUC of 0.72, and Accuracy of 0.69. Thus, we confirm that reply latency of texting has promise as a modality for depression screening.


Assuntos
Smartphone , Mídias Sociais , Envio de Mensagens de Texto , Depressão/diagnóstico , Inquéritos e Questionários
6.
Niger J Clin Pract ; 23(10): 1407-1413, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33047698

RESUMO

Aims: In this study, using Beck depression inventory (BDI), we aimed to determine alterations in the emotional state of patients who had impacted third molars (M3) extracted owing to postoperative pain, edema, and trismus.In this prospective clinical trial, which was conducted at Tokat Gaziosmanpasa University, Faculty of Dentistry, Department of Maxillofacial Surgery Clinic, we studied 60 patients (30 males and 30 females), who were 18-47 years old (the mean of 25.6 years of age). The patients with M3 with moderate preoperative pain intensities, edema, and maximal mouth opening (MMO) data were recorded, and BDI was applied to determine their emotional states. The patients were re-evaluated using BDI to detect alterations in their emotional state owing to pain intensity, edema, and trismus on postoperative second and seventh day. Subjects and Methods: Descriptive statistical analysis, Chi-square, and independent t-test were utilized to interpret the obtained data. Results: According to our findings, a statistically significant relationship was observed between BDI scores and gender on the second postoperative day (P = 0.004), and between MMO and BDI scores on the second and seventh postoperative day (P = 0.012, P = 0.045). Pain intensity scores on the postoperative sixth hour and seventh day were significantly correlated with BDI scores on the postoperative second and seventh day (P = 0.000/ P = 0.000/P = 0.002/P = 0.004/P = 0.010/P = 0.017/P = 0.001/P = 0.000). Conclusions: Our results suggest that the pain and trismus owing to the M3 surgery were significantly correlated with an increase in the postoperative BDI scores.


Assuntos
Depressão/diagnóstico , Edema/psicologia , Dente Serotino/cirurgia , Dor Pós-Operatória/psicologia , Extração Dentária/psicologia , Adolescente , Adulto , Cárie Dentária/epidemiologia , Depressão/epidemiologia , Depressão/psicologia , Edema/epidemiologia , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Período Pós-Operatório , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Extração Dentária/métodos , Extração Dentária/estatística & dados numéricos , Trismo/epidemiologia , Trismo/psicologia , Turquia/epidemiologia , Adulto Jovem
7.
Ann Glob Health ; 86(1): 128, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33102148

RESUMO

Background: COVID-19 first appeared in China in December 2019, with a high rate of infectivity and morbidity, which brought tremendous psychological pressure to healthcare workers. Purpose: To understand the psychological health status of healthcare workers during the COVID-19 outbreak and decline, and to provide a theoretical reference for the future establishment of a psychological crisis intervention system. Methods: Healthcare workers were recruited using convenience sampling and snowball sampling methods, and the electronic version of the SCL-90 scale and a sociodemographic questionnaire were administered. In the pretest, a total of 5018 responses were collected; after six weeks, random sampling was performed. The SCL-90 and measures of other epidemic-related problems were administered, with 1570 responses received; then, the final data analysis was performed. Results: After six weeks, the post-test GSI score; SCL-90 total score; and PST, PSDI, O-C, I-S, DEP, ANX, PHOB, PAR, PSY, and HOS scores were significantly lower than the corresponding pretest scores (p < 0.05). The results by occupational category showed that the scores of nursing staff decreased significantly for 12 indexes and that the scores of the doctors and other hospital staff also significantly decreased. There was a significant difference between the pretest (50.78 ± 28.18) and post-test (45.00 ± 28.49) scores for the degree of worry about the epidemic. Healthcare workers believed that the top three aspects of life affected by the epidemic were economic problems (816 people), interpersonal communication problems (731 people), and mental health (728 people). Conclusion: Over the course of the epidemic, the item scores generally declined significantly. Therefore, during an outbreak period, attention should be paid to psychological crisis interventions for healthcare workers; problems caused by psychological pressure, and even other psychological conditions, can be significantly alleviated to reduce the probability of subsequent health problems.


Assuntos
Ansiedade , Infecções por Coronavirus , Intervenção na Crise/métodos , Depressão , Pessoal de Saúde/psicologia , Pandemias , Pneumonia Viral , Estresse Psicológico , Adulto , Ansiedade/diagnóstico , Ansiedade/etiologia , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Depressão/etiologia , Feminino , Humanos , Masculino , Saúde Mental/estatística & dados numéricos , Estresse Ocupacional/classificação , Estresse Ocupacional/diagnóstico , Estresse Ocupacional/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Escalas de Graduação Psiquiátrica , Estresse Psicológico/diagnóstico , Estresse Psicológico/etiologia
9.
Chron Respir Dis ; 17: 1479973120962800, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33000648

RESUMO

INTRODUCTION: The COVID pandemic has had a high psychological impact on healthy populations. Increased levels of perceived stress, depression, and insomnia are expected, especially in people with pre-existing medical conditions, such as asthma and chronic obstructive pulmonary disease (COPD), who seem to be particularly vulnerable. However, the difference in psychological distress frequency between asthma and COPD patients is unknown. OBJECTIVE: To compare the prevalence of depression, perceived stress related to COVID, post-traumatic stress, and insomnia in asthma and COPD patients at a pulmonology clinic in Santa Marta, Colombia. METHODS: A cross-sectional study was designed. The patients were contacted by telephone. An electronic link was sent to those who accepted. The questionnaire asked for perceived stress related to COVID-19, post-traumatic stress symptoms, depressive symptoms, and insomnia risk. RESULTS: 148 asthma patients and 144 COPD patients participated in, between 18 and 96 years. The prevalence of high COVID-19 perceived stress was 10.6% (n = 31); post-traumatic stress risk, 11.3% (n = 33); depression risk, 31.5% (n = 92); and insomnia risk, 57.7% (n = 169). No significant differences were found between asthma and COPD in indicators of psychological distress. CONCLUSIONS: Asthma and COPD patients present similar frequencies of depression risk, COVID-19 perceived stress, post-traumatic stress risk, and insomnia risk during the Colombian lockdown. It is essential to evaluate and manage psychological distress among asthma and COPD patients. It can reduce the risk of exacerbation and improve the quality of life.


Assuntos
Asma , Infecções por Coronavirus , Depressão , Pandemias , Pneumonia Viral , Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono , Transtornos de Estresse Pós-Traumáticos , Asma/epidemiologia , Asma/psicologia , Betacoronavirus , Colômbia/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Depressão/etiologia , Depressão/psicologia , Autoavaliação Diagnóstica , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Angústia Psicológica , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Pesquisa Qualitativa , Autoimagem , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
10.
PLoS One ; 15(10): e0239211, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027307

RESUMO

BACKGROUND: The prevalence of psychological complaints is known to be very high in populations of asylum seekers. Despite this, data on the health care system's ability to adequately meet these high-risk populations' mental health needs are scarce. This article investigates how well the German outpatient health care system is able to detect and adequately treat them. METHODS: To this end, we combined data from a cross-sectional survey with billing data from the local social welfare office from the year 2015. Using descriptive statistics, the data of the cross-sectional study are used to quantify the psychological health care needs of asylum seekers while the secondary data analysis indicates the actual access to and extent of psychological treatment. RESULTS: In the cross-sectional study, 54% of patients were screened positive for symptoms of depression, 41% for symptoms of anxiety disorder and 18% for symptoms of Posttraumatic Stress Disorder. In total, 59% were screened positive for at least one of these three disorders. However, when contrasting these screening-based prevalences with the prevalences based on data from the health care system, a mismatch becomes apparent: According to the social welfare office's billing data, only 2.6% of asylum seekers received the diagnosis of depression, 1.4% were diagnosed with anxiety disorder and 2.9% with Posttraumatic Stress Disorder (PTSD). In combination, 4.9% were diagnosed with at least one of these three disorders. Overall, less than one tenth of asylum seekers with symptoms of depression, anxiety or PTSD received the corresponding diagnosis by the health care system. Among those who were diagnosed, about 45% received no treatment at all, while 38% were treated with drugs alone. Only 1% of all patients received psychotherapy. CONCLUSIONS: Psychological complaints are very common among asylum seekers, yet only a small proportion of this population receives the corresponding diagnoses and treatment. While various factors can contribute to these shortcomings, there is an urgent need to systematically address this deficit and introduce measures to improve mental health care for this high-risk population.


Assuntos
Saúde Mental , Refugiados/psicologia , Adolescente , Adulto , Antidepressivos/uso terapêutico , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/tratamento farmacológico , Estudos Transversais , Depressão/diagnóstico , Depressão/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicoterapia , Seguridade Social , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Inquéritos e Questionários , Adulto Jovem
12.
PLoS One ; 15(10): e0239210, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33017403

RESUMO

To evaluate the impact of Birdshot-Retinochoroidopathy (BSRC) and Serpiginous Choroiditis (SC) on depression, anxiety, and vision-related quality of life. 72 individuals (BSRC: n = 28, SC: n = 8; healthy control group (HC): n = 36) completed the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the Visual Function Questionnaire (VFQ-25). Multivariate linear regression models were used to analyze different subscales of the PHQ-9, the GAD-7 and the VFQ-25. The results showed that the mean of PHQ-9 was significantly higher while the mean of the VFQ-25 and its´ subscales were consistently lower in the disease group compared to HC. The mean of GAD-7 was not significantly lower in the disease group compared to HC. Stratification for different disease severity stages and duration of disease did not reveal any differences in sum scores of PHQ-9, GAD-7, and VFQ-25, whereas there were significant differences in some subscales of the VFQ-25. We conclude that BSRC and SC patients show higher levels of depression and a reduced visual quality of life due to imminent loss of vision. Because depression and quality of life are adversely affected by lack of social contacts and functioning, psychological treatment should enable patients to maintain their independence and ability to social interaction. Psychosomatic care should be taken in account for the treatment of BSRC and SC.


Assuntos
Transtornos de Ansiedade/etiologia , Coriorretinopatia de Birdshot/patologia , Depressão/etiologia , Qualidade de Vida , Transtornos da Visão/psicologia , Síndromes do Ponto Branco/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/diagnóstico , Coriorretinopatia de Birdshot/complicações , Estudos de Casos e Controles , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Perfil de Impacto da Doença , Estatísticas não Paramétricas , Transtornos da Visão/etiologia , Acuidade Visual , Síndromes do Ponto Branco/complicações
13.
Epidemiol Psychiatr Sci ; 29: e175, 2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33070799

RESUMO

AIMS: Previous studies regarding associations between depressive symptoms and suicidality (suicidal ideation, plans and attempts) have usually employed a variable-centred approach, without considering the individual variance in time-varying changes of depressive symptoms. Through 10-year follow-up of a large cohort of Chinese adolescents exposed to the 2008 Wenchuan earthquake, this study examined whether individual variance in depressive symptoms during the early phases post-earthquake could generate different suicidality outcomes in young adulthood. METHODS: A total of 1357 Chinese adolescents exposed to the Wenchuan earthquake were surveyed on depressive symptoms and other variables at 6, 18 and 30 months post-earthquake. In total, 799 participants responded to the 10-year follow-up and completed an online survey covering suicidality and other variables. The analytic sample was 744 participants who had valid data on depressive symptoms and suicidality. Data were analysed using logistic regressions. RESULTS: Prevalence estimates of past-year suicidal ideation, suicide plans and suicide attempts measured at 10 years post-earthquake were found to be 10.8%, 7.3% and 3.0%, respectively. Five trajectories of depressive symptoms were classified: resistance (54.4%), chronicity (13.3%), recovery (10.4%), delayed dysfunction (12.0%) and relapsing/remitting (10.0%). After controlling for covariates, whole-sample regressions revealed only the relapsing/remitting depressive trajectory remained significantly predictive of suicidality. Moreover, males not females in the chronic group were more likely to have suicide plans. CONCLUSIONS: The findings highlight the importance of detecting disaster survivors with different trajectories of mental status and providing with them individualised and effective mental health services, to decrease their risk of suicidality in the future.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Terremotos , Transtornos de Estresse Pós-Traumáticos/psicologia , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Adaptação Psicológica , Adolescente , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Estudos de Coortes , Depressão/diagnóstico , Depressão/etnologia , Depressão/psicologia , Feminino , Seguimentos , Humanos , Masculino , Prevalência , Fatores de Risco , Distribuição por Sexo , Transtornos de Estresse Pós-Traumáticos/etnologia , Suicídio/psicologia , Tentativa de Suicídio/psicologia , Inquéritos e Questionários , Sobreviventes
14.
Sci Adv ; 6(42)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32948511

RESUMO

The COVID-19 (coronavirus disease 2019) pandemic is a collective stressor unfolding over time; yet, rigorous empirical studies addressing its mental health consequences among large probability-based national samples are rare. Between 18 March and 18 April 2020, as illness and death escalated in the United States, we assessed acute stress, depressive symptoms, and direct, community, and media-based exposures to COVID-19 in three consecutive representative samples from the U.S. probability-based nationally representative NORC AmeriSpeak panel across three 10-day periods (total N = 6514). Acute stress and depressive symptoms increased significantly over time as COVID-19 deaths increased across the United States. Preexisting mental and physical health diagnoses, daily COVID-19-related media exposure, conflicting COVID-19 information in media, and secondary stressors were all associated with acute stress and depressive symptoms. Results have implications for targeting public health interventions and risk communication efforts to promote community resilience as the pandemic waxes and wanes over time.


Assuntos
Infecções por Coronavirus/patologia , Saúde Mental , Pneumonia Viral/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/isolamento & purificação , Estudos de Coortes , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Depressão/diagnóstico , Depressão/etiologia , Feminino , Humanos , Análise dos Mínimos Quadrados , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Estresse Psicológico , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
15.
J Stroke Cerebrovasc Dis ; 29(10): 105149, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32912541

RESUMO

BACKGROUND AND AIMS: Experimental studies demonstrated that netrin-1 (NT-1) is an important factor influencing the recovery after ischemic stroke. However, whether NT-1 levels were associated with the post-stroke depression (PSD) remains unclear. We aimed to evaluate the relationship between NT-1 levels and PSD at 3 months in patients with ischemic stroke. METHODS: From January 2018 to December 2019, consecutive Chinese patients with first-ever ischemic stroke were prospectively recruited. Serum NT-1 levels were measured at admission. Patients with a 17-item Hamilton Depression Scale score of ≥7 were given the Structured Clinical Interview of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, for diagnosis of PSD. RESULTS: A total of 238 patients (mean age, 62.5 years; 45.4% female) were enrolled. The median NT-1 concentrations were 467.8 pg/mL (interquartile range, 351.8-581.0 pg/mL). During the 3-month follow-up period, 64 patients (26.9%) experienced PSD. Serum NT-1 levels were significantly lower in PSD patients than in patients without PSD (median, 380.3 pg/mL versus 478.5 pg/mL; P = 0.001). After adjusting for demographic characteristic, National Institutes of Health stroke score, and other potential confounders by multiple logistic regression analysis, patients with NT-1 levels in the first quartile were more likely to have 3-month PSD (as compared with the fourth quartile, odds ratio 3.83, 95% confidence intervals, 1.53-9.63, P = 0.004). Similar significant findings were observed when the NT-1 levels were added as a continuous variable. CONCLUSIONS: Our data demonstrated that decreased serum NT-1 levels, in a Chinese population, were significantly associated with PSD at 3 months.


Assuntos
Depressão/sangue , Netrina-1/sangue , Acidente Vascular Cerebral/sangue , Idoso , Biomarcadores/sangue , China , Depressão/diagnóstico , Depressão/etiologia , Regulação para Baixo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Fatores de Tempo
16.
Pediatr Emerg Care ; 36(9): 424-429, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32870615

RESUMO

OBJECTIVES: Suicide is a leading cause of adolescent death, and emergency department (ED) visits are recognized as an opportunity to identify at-risk youth. For patients screening positive for mental health concerns, we implemented a quality improvement initiative to enhance documentation of results and interventions in the ED, increase communication between the ED and primary care providers (PCPs), and increase PCP follow-up. METHODS: Interventions included education, feedback, and an alert in our electronic health record. Completion of a Behavioral Health Screen (BHS-ED) initiates an alert that reminds ED providers how to document and communicate results and needed follow-up to the PCP. We reviewed a random monthly sample of ED charts for adolescents 14 to 19 years old presenting with nonpsychiatric complaints who screened positive for severe depression or suicidality. Outcome measures included documentation of BHS-ED results in the ED note, communication of positive results to the PCP, PCP follow-up of results, and ED return visits. RESULTS: Documentation of BHS-ED results increased from 73% at baseline to 88% of patients after the intervention. For patients discharged from the ED with nonpsychiatric chief complaints, communication to PCPs increased from 1% at baseline to 40% during the final 3 months of the study. When PCP communication occurred, 67% of in-network PCPs followed up with patients versus 5% when no communication took place from the ED. CONCLUSIONS: A multifaceted intervention including education and an electronic health record alert improved ED documentation, communication, and PCP follow-up of issues identified during ED-based mental health screens.


Assuntos
Comunicação , Registros Eletrônicos de Saúde , Serviço Hospitalar de Emergência , Saúde Mental , Sumários de Alta do Paciente Hospitalar , Atenção Primária à Saúde , Adolescente , Assistência ao Convalescente , Depressão/diagnóstico , Documentação , Humanos , Capacitação em Serviço , Programas de Rastreamento , Melhoria de Qualidade , Suicídio/prevenção & controle , Adulto Jovem
17.
J Med Internet Res ; 22(9): e19716, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32975521

RESUMO

BACKGROUND: Most people who experience a potentially traumatic event (PTE) recover on their own. A small group of individuals develops psychological complaints, but this is often not detected in time or guidance to care is suboptimal. To identify these individuals and encourage them to seek help, a web-based self-help test called Mobile Insight in Risk, Resilience, and Online Referral (MIRROR) was developed. MIRROR takes an innovative approach since it integrates both negative and positive outcomes of PTEs and time since the event and provides direct feedback to the user. OBJECTIVE: The goal of this study was to assess MIRROR's use, examine its psychometric properties (factor structure, internal consistency, and convergent and divergent validity), and evaluate how well it classifies respondents into different outcome categories compared with reference measures. METHODS: MIRROR was embedded in the website of Victim Support Netherlands so visitors could use it. We compared MIRROR's outcomes to reference measures of PTSD symptoms (PTSD Checklist for DSM-5), depression, anxiety, stress (Depression Anxiety Stress Scale-21), psychological resilience (Resilience Evaluation Scale), and positive mental health (Mental Health Continuum Short Form). RESULTS: In 6 months, 1112 respondents completed MIRROR, of whom 663 also completed the reference measures. Results showed good internal consistency (interitem correlations range .24 to .55, corrected item-total correlations range .30 to .54, and Cronbach alpha coefficient range .62 to .68), and convergent and divergent validity (Pearson correlations range -.259 to .665). Exploratory and confirmatory factor analyses (EFA+CFA) yielded a 2-factor model with good model fit (CFA model fit indices: χ219=107.8, P<.001, CFI=.965, TLI=.948, RMSEA=.065), conceptual meaning, and parsimony. MIRROR correctly classified respondents into different outcome categories compared with the reference measures. CONCLUSIONS: MIRROR is a valid and reliable self-help test to identify negative (PTSD complaints) and positive outcomes (psychosocial functioning and resilience) of PTEs. MIRROR is an easily accessible online tool that can help people who have experienced a PTE to timely identify psychological complaints and find appropriate support, a tool that might be highly needed in times like the coronavirus pandemic.


Assuntos
Inquéritos Epidemiológicos , Aplicativos Móveis , Encaminhamento e Consulta , Resiliência Psicológica , Autocuidado/métodos , Autocuidado/normas , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Ansiedade/diagnóstico , Lista de Checagem , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Análise Fatorial , Feminino , Humanos , Internet , Masculino , Países Baixos/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Psicometria , Reprodutibilidade dos Testes , Estresse Psicológico/diagnóstico
18.
BMC Psychol ; 8(1): 99, 2020 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-32962764

RESUMO

BACKGROUND: Pregnancy as a sensitive period of a woman's life can be affected by various psychological factors that can have adverse effects on the woman, her fetus and future baby. Since COVID-19 is a new phenomenon with limited information available, it may have adverse psychological effects on pregnant women. Therefore, this study was conducted to determine the status of depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID-19. METHODS: This descriptive-analytical cross-sectional study was performed on 205 pregnant women covered by Tabriz health centers in Iran. The sampling method used was cluster sampling. The data collection tool was the socio-demographic characteristics questionnaire and the DASS-21 (Depression, Anxiety and Stress Scale-21), which were completed online by pregnant women. The general linear model was used to determine the predictive factors of depression, anxiety and stress. RESULTS: The mean (SD) score of depression, stress, and anxiety were 3.91 (3.9), 6.22 (4.25), and 3.79 (3.39), respectively; the score range of 0 to 21. Depression, stress, and anxiety symptoms were observed in 32.7, 32.7, and 43.9% of the participants, respectively, with varying degrees from mild to very severe. Based on the adjusted general linear model, variables of education level, spouse's job and marital life satisfaction were the predictors of depressive symptoms. Variables of spouse's education level, spouse's support, marital life satisfaction and the number of pregnancies were the predictive factors of anxiety symptoms and the variables of spouse's education level, household income sufficiency, spouse's support and marital life satisfaction were predictors of stress symptoms. CONCLUSIONS: Considering the role of marital life satisfaction, high level of spouse's education and income in reducing symptoms of stress, anxiety, and depression in pregnant women in critical situations such as the prevalence of COVID-19, it seems that using strategies to promote marital life satisfaction and socio-economic status can play an effective role in controlling anxiety and reducing stress and depression in pregnant women.


Assuntos
Ansiedade , Infecções por Coronavirus , Depressão , Casamento , Pandemias , Pneumonia Viral , Complicações na Gravidez , Estresse Psicológico , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/prevenção & controle , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/prevenção & controle , Complicações na Gravidez/psicologia , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Fatores Socioeconômicos , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia , Estresse Psicológico/prevenção & controle
19.
Transl Psychiatry ; 10(1): 319, 2020 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-32950999

RESUMO

Coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide, with a staggering number of cases and deaths. However, available data on the psychological impacts of COVID-19 on pregnant women are limited. The purposes of this study were to assess the prevalence of psychiatric symptoms among pregnant women, and to compare them with non-pregnant women. From February 28 to March 12, 2020, a cross-sectional study of pregnant and non-pregnant women was performed in China. The online questionnaire was used to collect information of participants. The mental health status was assessed by patient health questionnaire, generalized anxiety disorder scale, insomnia severity index, somatization subscale of the symptom checklist 90, and post-traumatic stress disorder (PTSD) checklist-5. Totally, 859 respondents were enrolled, including 544 pregnant women and 315 non-pregnant women. In this study, 5.3%, 6.8%, 2.4%, 2.6%, and 0.9% of pregnant women were identified to have symptoms of depression, anxiety, physical discomfort, insomnia, and PTSD, respectively. However, the corresponding prevalence rates among non-pregnant women were 17.5%, 17.5%, 2.5%, 5.4%, 5.7%, respectively. After adjusting for other covariates, we observed that pregnancy was associated a reduced risk of symptoms of depression (OR = 0.23; 95% CI: 0.12-0.45), anxiety (OR = 0.26; 95% CI: 0.16-0.42), insomnia (OR = 0.19; 95% CI: 0.06-0.58), and PTSD (OR = 0.15; 95% CI: 0.04-0.53) during the COVID-19 epidemic. Our results indicate that during the COVID-19 epidemic in China, pregnant women have an advantage of facing mental problems caused by COVID-19, showing fewer depression, anxiety, insomnia, and PTSD symptoms than non-pregnant women.


Assuntos
Ansiedade , Infecções por Coronavirus , Depressão , Pandemias , Pneumonia Viral , Gestantes/psicologia , Distúrbios do Início e da Manutenção do Sono , Transtornos Somatoformes , Transtornos de Estresse Pós-Traumáticos , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Saúde Mental/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Gravidez , Pesquisa Qualitativa , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia
20.
Medicine (Baltimore) ; 99(38): e22260, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957375

RESUMO

We explored the psychological changes in suspected patients during the coronavirus disease 2019 (COVID-19) epidemic and obtained evidence for early psychological guidance and intervention in this group. A total of 31 inpatients with suspected COVID-19 were identified at our hospital. The depression module of the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder (GAD)-7 scale, and the Self-Reporting Questionnaire (SRQ-20) mental health self-assessment questionnaire were used to assess depression, anxiety, and overall mental health. Among the patients, 32.3% had symptoms of depression and 19.4% had symptoms of anxiety. Levels of anxiety and fear varied. In comparing the PHQ-9 and 7-item Generalized Anxiety Disorder Scale scores of suspected and confirmed patients, there was no significant difference in the distribution of severity of anxiety or depression in the 2 groups. The PHQ-9 scores indicated mild depression symptoms in 25.8% of suspected patients, moderate symptoms in 0%, and severe symptoms in 6.5%. Overall, 50% of confirmed patients had symptoms, with 30.8% classified as mild, 15.4% classified as moderate, and 3.8% classified as severe. The 7-item Generalized Anxiety Disorder Scale scores in the group of suspected patients showed that 9.7% had mild symptoms, 0% had moderate symptoms, and 9.7% had severe symptoms. In the group of confirmed patients, 38.4% had symptoms (34.6% mild, 0% moderate, and 3.8% severe). Diagnosed patients had more visible symptoms of depression and different total PHQ-9 scores. During the COVID-19 epidemic, suspected and diagnosed patients had different levels of mental health problems. Diagnosed patients had more visible symptoms. The performance of suspected patients was higher, but their mental state was more polarized. It may thus be important to monitor the psychological state of suspected patients as early as possible to enable timely interventions that promote psychological rehabilitation.


Assuntos
Ansiedade/diagnóstico , Betacoronavirus , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Pneumonia Viral/psicologia , Adulto , Idoso , Ansiedade/epidemiologia , Ansiedade/virologia , China/epidemiologia , Infecções por Coronavirus/virologia , Depressão/epidemiologia , Depressão/virologia , Medo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Inquéritos e Questionários
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