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1.
Int J Mol Sci ; 22(5)2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33802338

RESUMO

Early life stress (ELS) is strongly associated with psychiatric disorders such as anxiety, depression, and schizophrenia in adulthood. To date, biological, behavioral, and structural aspects of ELS have been studied extensively, but their functional effects remain unclear. Here, we examined NeuroPET studies of dopaminergic, glutamatergic, and serotonergic systems in ELS animal models. Maternal separation and restraint stress were used to generate single or complex developmental trauma. Body weights of animals exposed to single trauma were similar to those of control animals; however, animals exposed to complex trauma exhibited loss of body weight when compared to controls. In behavioral tests, the complex developmental trauma group exhibited a decrease in time spent in the open arm of the elevated plus-maze and an increase in immobility time in the forced swim test when compared to control animals. In NeuroPET studies, the complex trauma group displayed a reduction in brain uptake values when compared to single trauma and control groups. Of neurotransmitter systems analyzed, the rate of decrease in brain uptake was the highest in the serotonergic group. Collectively, our results indicate that developmental trauma events induce behavioral deficits, including anxiety- and depressive-like phenotypes and dysfunction in neurotransmitter systems.


Assuntos
Encéfalo/metabolismo , Encéfalo/fisiologia , Neurotransmissores/metabolismo , Ferimentos e Lesões/metabolismo , Ferimentos e Lesões/fisiopatologia , Animais , Animais Recém-Nascidos/metabolismo , Animais Recém-Nascidos/fisiologia , Ansiedade/metabolismo , Ansiedade/fisiopatologia , Transtornos de Ansiedade/metabolismo , Transtornos de Ansiedade/fisiopatologia , Comportamento Animal/fisiologia , Depressão/metabolismo , Depressão/fisiopatologia , Modelos Animais de Doenças , Comportamento Exploratório/fisiologia , Feminino , Masculino , Privação Materna , Aprendizagem em Labirinto/fisiologia , Imagem Molecular/métodos , Ratos , Ratos Sprague-Dawley , Estresse Psicológico/metabolismo , Estresse Psicológico/fisiopatologia , Natação/fisiologia
2.
Nat Commun ; 12(1): 2275, 2021 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-33859187

RESUMO

Individuals may show different responses to stressful events. Here, we investigate the neurobiological basis of stress resilience, by showing that neural responsitivity of the noradrenergic locus coeruleus (LC-NE) and associated pupil responses are related to the subsequent change in measures of anxiety and depression in response to prolonged real-life stress. We acquired fMRI and pupillometry data during an emotional-conflict task in medical residents before they underwent stressful emergency-room internships known to be a risk factor for anxiety and depression. The LC-NE conflict response and its functional coupling with the amygdala was associated with stress-related symptom changes in response to the internship. A similar relationship was found for pupil-dilation, a potential marker of LC-NE firing. Our results provide insights into the noradrenergic basis of conflict generation, adaptation and stress resilience.


Assuntos
Internato e Residência , Locus Cerúleo/fisiopatologia , Estresse Ocupacional/diagnóstico , Resiliência Psicológica , Adulto , Tonsila do Cerebelo/fisiopatologia , Ansiedade/epidemiologia , Ansiedade/fisiopatologia , Ansiedade/psicologia , Conectoma , Depressão/epidemiologia , Depressão/fisiopatologia , Depressão/psicologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Locus Cerúleo/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/fisiopatologia , Valor Preditivo dos Testes , Fatores de Risco , Estudantes de Medicina/psicologia , Adulto Jovem
3.
Nat Neurosci ; 24(4): 542-553, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33686297

RESUMO

In humans, tissue injury and depression can both cause pain hypersensitivity, but whether this involves distinct circuits remains unknown. Here, we identify two discrete glutamatergic neuronal circuits in male mice: a projection from the posterior thalamic nucleus (POGlu) to primary somatosensory cortex glutamatergic neurons (S1Glu) mediates allodynia from tissue injury, whereas a pathway from the parafascicular thalamic nucleus (PFGlu) to anterior cingulate cortex GABA-containing neurons to glutamatergic neurons (ACCGABA→Glu) mediates allodynia associated with a depression-like state. In vivo calcium imaging and multi-tetrode electrophysiological recordings reveal that POGlu and PFGlu populations undergo different adaptations in the two conditions. Artificial manipulation of each circuit affects allodynia resulting from either tissue injury or depression-like states, but not both. Our study demonstrates that the distinct thalamocortical circuits POGlu→S1Glu and PFGlu→ACCGABA→Glu subserve allodynia associated with tissue injury and depression-like states, respectively, thus providing insights into the circuit basis of pathological pain resulting from different etiologies.


Assuntos
Depressão/fisiopatologia , Hiperalgesia/fisiopatologia , Vias Neurais/fisiologia , Córtex Somatossensorial/fisiologia , Tálamo/fisiologia , Animais , Masculino , Camundongos , Neurônios/fisiologia
4.
J Med Case Rep ; 15(1): 108, 2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33653380

RESUMO

BACKGROUND: Hypothyroidism is diagnosed on the basis of laboratory tests because of the lack of specificity of the typical clinical manifestations. There is conflicting evidence on screening for hypothyroidism. CASE PRESENTATION: We report a case of an apparently healthy 19-year-old Kuwaiti woman referred to our clinic with an incidental finding of extremely high thyroid-stimulating hormone (TSH), tested at the patient's insistence as she had a strong family history of hypothyroidism. Despite no stated complaints, the patient presented typical symptoms and signs of hypothyroidism on evaluation. Thyroid function testing was repeated by using different assays, with similar results; ultrasound imaging of the thyroid showed a typical picture of thyroiditis. Treatment with levothyroxine alleviated symptoms and the patient later became biochemically euthyroid on treatment. CONCLUSION: There is controversy regarding screening asymptomatic individuals for hypothyroidism; therefore, it is important to maintain a high index of suspicion when presented with mild signs and symptoms of hypothyroidism especially with certain ethnic groups, as they may be free of the classical symptoms of disease.


Assuntos
Hipotireoidismo/diagnóstico , Tireoidite Autoimune/diagnóstico , Alopecia/fisiopatologia , Apetite , Autoanticorpos/imunologia , Constipação Intestinal/fisiopatologia , Depressão/fisiopatologia , Fadiga/fisiopatologia , Feminino , Humanos , Hipotireoidismo/sangue , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/fisiopatologia , Achados Incidentais , Iodeto Peroxidase/imunologia , Menorragia/fisiopatologia , Índice de Gravidade de Doença , Glândula Tireoide/diagnóstico por imagem , Tireoidite Autoimune/sangue , Tireoidite Autoimune/imunologia , Tireoidite Autoimune/fisiopatologia , Tireotropina/sangue , Tiroxina/sangue , Tiroxina/uso terapêutico , Ultrassonografia , Ganho de Peso , Adulto Jovem
5.
Curr Urol Rep ; 22(4): 21, 2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33554319

RESUMO

PURPOSE OF REVIEW: Benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) is a disease complex with enormous societal burden and yet the pathogenesis of LUTS/BPH is poorly understood. We set out to review the literature on the relationship between depression, marijuana usage, and erectile dysfunction (ED) to LUTS/BPH. RECENT FINDINGS: LUTS/BPH has independent associations with depression as well as with ED. In each case, the causality and mechanistic relationship is unknown. The impact of marijuana, as it increasingly pervades the general population, on the disease complex of LUTS/BPH is not well studied but recent results support short-term benefit and long-term caution. Depression, a form of central nervous dysfunction, and ED, which is likely mediated via endothelial dysfunction, are independently associated with LUTS/BPH. The presence of cannabinoid receptors in urologic organs, coupled with recent population studies, supports a modulatory effect of marijuana on voiding although an enormous knowledge gap remains.


Assuntos
Depressão , Disfunção Erétil , Sintomas do Trato Urinário Inferior , Fumar Maconha , Hiperplasia Prostática , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/fisiopatologia , Depressão/fisiopatologia , Depressão/psicologia , Disfunção Erétil/etiologia , Disfunção Erétil/psicologia , Disfunção Erétil/terapia , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/psicologia , Sintomas do Trato Urinário Inferior/terapia , Masculino , Fumar Maconha/efeitos adversos , Fumar Maconha/fisiopatologia , Fumar Maconha/psicologia , Fumar Maconha/terapia , Hiperplasia Prostática/etiologia , Hiperplasia Prostática/psicologia , Hiperplasia Prostática/terapia , Fatores de Tempo
6.
Psychopharmacology (Berl) ; 238(4): 949-958, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33544194

RESUMO

Clinical evidence shows that chronic pain and depression often accompany each other, but the underlying pathogenesis of comorbid chronic pain and depression remains mostly undetermined. Biotechnology is gradually revealing the phenotype and function of microglia, with great progress regarding microglia's role in neurodegeneration, depression, chronic pain, and other conditions. This article summarizes the role of microglia in chronic pain, depression, and comorbidities, which is conducive to finding new targets to treat chronic pain and depression.


Assuntos
Dor Crônica/fisiopatologia , Depressão/fisiopatologia , Microglia , Animais , Comorbidade , Humanos
7.
BMC Neurol ; 21(1): 68, 2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-33573615

RESUMO

BACKGROUND: Depression in essential tremor (ET) has been constantly studied and reported, while the associated brain activity changes remain unclear. Recently, regional homogeneity (ReHo), a voxel-wise local functional connectivity (FC) analysis of resting-state functional magnetic resonance imaging, has provided a promising way to observe spontaneous brain activity. METHODS: Local FC analyses were performed in forty-one depressed ET patients, 49 non-depressed ET patients and 43 healthy controls (HCs), and then matrix FC and clinical depression severity correlation analyses were further performed to reveal spontaneous neural activity changes in depressed ET patients. RESULTS: Compared with the non-depressed ET patients, the depressed ET patients showed decreased ReHo in the bilateral cerebellum lobules IX, and increased ReHo in the bilateral anterior cingulate cortices and middle prefrontal cortices. Twenty-five significant changes of ReHo clusters were observed in the depressed ET patients compared with the HCs, and matrix FC analysis further revealed that inter-ROI FC differences were also observed in the frontal-cerebellar-anterior cingulate cortex pathway. Correlation analyses showed that clinical depression severity was positively correlated with the inter-ROI FC values between the anterior cingulate cortex and bilateral middle prefrontal cortices and was negatively correlated with the inter-ROI FC values of the anterior cingulate cortex and bilateral cerebellum lobules IX. CONCLUSION: Our findings revealed local and inter-ROI FC differences in frontal-cerebellar-anterior cingulate cortex circuits in depressed ET patients, and among these regions, the cerebellum lobules IX, middle prefrontal cortices and anterior cingulate cortices could function as pathogenic structures underlying depression in ET patients.


Assuntos
Encéfalo/fisiopatologia , Depressão/etiologia , Depressão/fisiopatologia , Tremor Essencial/fisiopatologia , Tremor Essencial/psicologia , Adulto , Mapeamento Encefálico/métodos , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Rede Nervosa/fisiopatologia
8.
J Prev Med Public Health ; 54(1): 63-72, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33618501

RESUMO

OBJECTIVES: Recent studies have suggested that assessing handgrip strength (HGS) asymmetry together with HGS may be helpful for evaluating problems in geriatric patients. This study aimed to identify whether HGS asymmetry, weakness, or both were associated with depression in Korean older adults. METHODS: This study included 4274 subjects from the sixth and seventh Korea National Health and Nutrition Examination Survey. Depression was measured using the Patient Health Questionnaire-9. The maximum HGS of the dominant hand was used as a representative value. HGS symmetry was categorized by the ratio of the HGS of the dominant hand to that of non-dominant hand. The odds ratio (OR) for depression was calculated according to the HGS and its symmetry. RESULTS: In total, 240 (12.5%) men and 534 (22.7%) women had depression. HGS or HGS asymmetry showed no statistically significant associations with depression in elderly men. Elevated odds of depression were observed in elderly women with low HGS (OR, 1.93; 95% confidence interval [CI], 1.33 to 2.81) or prominent HGS asymmetry (OR, 1.46; 95% CI, 1.02 to 2.08). There was a positive additive interaction between asymmetric HGS and weakness, as women with low and prominently asymmetric HGS showed higher odds of depression (OR, 3.77; 95% CI, 2.16 to 6.59) than women with high and symmetric HGS. CONCLUSIONS: Depression in elderly Korean women was associated with both low and asymmetric HGS. Our findings support the potential value of HGS asymmetry as an indicator of HGS.


Assuntos
Depressão/complicações , Força da Mão/fisiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Depressão/fisiopatologia , Depressão/psicologia , Feminino , Geriatria/instrumentação , Geriatria/métodos , Geriatria/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , República da Coreia
10.
PLoS One ; 16(1): e0244929, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33481838

RESUMO

A novel conversation-analytically informed paradigm was used to examine how joint decision-making interaction, with its various types of proposal sequences, is reflected in the physiological responses of participants. Two types of dyads-dyads with one depressed and one non-depressed participant (N = 15) and dyads with two non-depressed participants (N = 15)-engaged in a series of conversational joint decision-making tasks, during which we measured their skin conductance (SC) responses. We found that the participants' SC response rates were higher and more synchronized during proposal sequences than elsewhere in the conversation. Furthermore, SC response rates were higher when the participant was in the role of a proposal speaker (vs. a proposal recipient), and making a proposal was associated with higher SC response rates for participants with depression (vs. participants without depression). Moreover, the SC response rates in the proposal speaker were higher when the recipient accepted (vs. not accepted) the proposal. We interpret this finding with reference to accepting responses suggesting a commitment to future action, for which the proposal speaker may feel specifically responsible for. A better understanding of the physiological underpinnings of joint decision-making interaction may help improve democratic practices in contexts where certain individuals experience challenges in this regard.


Assuntos
Tomada de Decisões/fisiologia , Adulto , Depressão/fisiopatologia , Depressão/psicologia , Feminino , Resposta Galvânica da Pele , Humanos , Masculino
11.
J Ethnopharmacol ; 265: 113395, 2021 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32956757

RESUMO

ETHNOPHARMACOLOGY RELEVANCE: Armillaria mellea (Vahl) P. Kumm. (AM) is an edible mushroom that has been reported as treatment for several neurological disorders, such as dizziness and epilepsy in Asia. Importantly, AM shares a symbiotic relationship with Gastrodia elata Blume (GE), a medicinal herb with antidepressant-like properties. Researchers believe that AM may possess pharmacological properties similar to GE due to their symbiosis, however, few studies have investigated the pharmacological effect of AM. AIM OF THE STUDY: The aim of this study was to explore the potential of AM as an antidepressant in forced-swimming test (FST) and unpredictable chronic mild stress (UCMS) rodent models and investigate its possible underlying mechanism. MATERIALS AND METHODS: Rats were orally administrated with 250, 500, and 1000 mg/kg body weight (bw) water extract of AM (WAM) for 28 and 35 consecutive days prior to the FST and UCMS protocols, respectively. The cerebral serotonin (5-HT) and the metabolites in the frontal cortex of rats were measured. The brain was dissected and the blood was collected to investigate the levels of inflammatory-related signaling pathway. RESULTS: All doses of WAM reduced the immobility time in the FST without disturbing autonomic locomotion. All doses of WAM prevented stress-induced abnormal behaviors in the UCMS model, including decreased sucrose preference and hypoactivity. 500 and 1000 mg/kg bw WAM attenuated the stress-induced increases in IL-1ß and TNF-α in the serum and cerebrum. 1000 mg/kg bw WAM alleviated brain inflammation by reducing the protein expression of ionized calcium binding adaptor molecule 1. CONCLUSION: WAM exhibited acute and chronic antidepressant-like effects, and may result from the anti-inflammatory actions. Therefore, the development of AM as a dietary therapy or adjuvant for depression treatment should be considered.


Assuntos
Anti-Inflamatórios/farmacologia , Antidepressivos/farmacologia , Armillaria/química , Depressão/tratamento farmacológico , Animais , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/isolamento & purificação , Antidepressivos/administração & dosagem , Antidepressivos/isolamento & purificação , Comportamento Animal/efeitos dos fármacos , Depressão/fisiopatologia , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Inflamação/tratamento farmacológico , Inflamação/patologia , Masculino , Ratos , Ratos Sprague-Dawley , Serotonina/metabolismo , Estresse Psicológico/tratamento farmacológico , Estresse Psicológico/fisiopatologia , Natação , Água
12.
Methods Mol Biol ; 2130: 69-78, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33284436

RESUMO

The forced swim and tail suspension tests are commonly used to determine the effects of circadian-related pharmacological, genetic, and environmental manipulations on depression-like behavior in rodents. Both tests involve scoring immobility of rodents in an inescapable condition. Here we describe how to set up and carry out these tests.


Assuntos
Ritmo Circadiano , Depressão/fisiopatologia , Elevação dos Membros Posteriores/métodos , Condicionamento Físico Animal/métodos , Animais , Depressão/etiologia , Elevação dos Membros Posteriores/normas , Camundongos , Condicionamento Físico Animal/normas , Natação
13.
PLoS Comput Biol ; 16(12): e1008484, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33315893

RESUMO

Recent neurocomputational theories have hypothesized that abnormalities in prior beliefs and/or the precision-weighting of afferent interoceptive signals may facilitate the transdiagnostic emergence of psychopathology. Specifically, it has been suggested that, in certain psychiatric disorders, interoceptive processing mechanisms either over-weight prior beliefs or under-weight signals from the viscera (or both), leading to a failure to accurately update beliefs about the body. However, this has not been directly tested empirically. To evaluate the potential roles of prior beliefs and interoceptive precision in this context, we fit a Bayesian computational model to behavior in a transdiagnostic patient sample during an interoceptive awareness (heartbeat tapping) task. Modelling revealed that, during an interoceptive perturbation condition (inspiratory breath-holding during heartbeat tapping), healthy individuals (N = 52) assigned greater precision to ascending cardiac signals than individuals with symptoms of anxiety (N = 15), depression (N = 69), co-morbid depression/anxiety (N = 153), substance use disorders (N = 131), and eating disorders (N = 14)-who failed to increase their precision estimates from resting levels. In contrast, we did not find strong evidence for differences in prior beliefs. These results provide the first empirical computational modeling evidence of a selective dysfunction in adaptive interoceptive processing in psychiatric conditions, and lay the groundwork for future studies examining how reduced interoceptive precision influences visceral regulation and interoceptively-guided decision-making.


Assuntos
Ansiedade/fisiopatologia , Teorema de Bayes , Simulação por Computador , Depressão/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Sobrepeso/fisiopatologia , Magreza/fisiopatologia , Adulto Jovem
14.
Sci Rep ; 10(1): 22346, 2020 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-33339879

RESUMO

The risk of relapsing into depression after stopping antidepressants is high, but no established predictors exist. Resting-state functional magnetic resonance imaging (rsfMRI) measures may help predict relapse and identify the mechanisms by which relapses occur. rsfMRI data were acquired from healthy controls and from patients with remitted major depressive disorder on antidepressants. Patients were assessed a second time either before or after discontinuation of the antidepressant, and followed up for six months to assess relapse. A seed-based functional connectivity analysis was conducted focusing on the left subgenual anterior cingulate cortex and left posterior cingulate cortex. Seeds in the amygdala and dorsolateral prefrontal cortex were explored. 44 healthy controls (age: 33.8 (10.5), 73% female) and 84 patients (age: 34.23 (10.8), 80% female) were included in the analysis. 29 patients went on to relapse and 38 remained well. The seed-based analysis showed that discontinuation resulted in an increased functional connectivity between the right dorsolateral prefrontal cortex and the parietal cortex in non-relapsers. In an exploratory analysis, this functional connectivity predicted relapse risk with a balanced accuracy of 0.86. Further seed-based analyses, however, failed to reveal differences in functional connectivity between patients and controls, between relapsers and non-relapsers before discontinuation and changes due to discontinuation independent of relapse. In conclusion, changes in the connectivity between the dorsolateral prefrontal cortex and the posterior default mode network were associated with and predictive of relapse after open-label antidepressant discontinuation. This finding requires replication in a larger dataset.


Assuntos
Antidepressivos/efeitos adversos , Giro do Cíngulo/diagnóstico por imagem , Vias Neurais/diagnóstico por imagem , Córtex Pré-Frontal/diagnóstico por imagem , Adulto , Tonsila do Cerebelo/diagnóstico por imagem , Tonsila do Cerebelo/patologia , Antidepressivos/uso terapêutico , Mapeamento Encefálico , Depressão/complicações , Depressão/diagnóstico por imagem , Depressão/tratamento farmacológico , Depressão/fisiopatologia , Feminino , Giro do Cíngulo/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Vias Neurais/patologia , Córtex Pré-Frontal/patologia , Recidiva , Prevenção Secundária
15.
Psychiatr Danub ; 32(3-4): 373-379, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33370735

RESUMO

BACKGROUND: Regular practice of physical activity is associated with better quality of life and functioning in people with bipolar disorder, schizophrenia and depression. However, to the best of our knowledge, there is no evidence of the association between physical activity and quality of life and global functioning among people in the initial stages of psychosis. The aim to explore the association of the level of physical activity with quality of life and global functioning among patients in early stages of psychosis. SUBJECTS AND METHODS: Cross-sectional study carried out in an early intervention program in 2016. The socio-demographic and clinical variables were assessed via a form; the adherence through the Measurement of Treatment Adherence; the global functioning through the Global Assessment of Functioning (GAF) scale; the level of physical activity through the International Physical Activity Questionnaire (IPAQ) and quality of life through the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). The Mann-Whitney test was used for analysis. RESULTS: A total of eighty-five participants (mean age=32, 57.6% were men) were assessed. Of the 85, 46 (54.1%) were classified as physically active. The physically active patients presented higher values, on average (standard deviation), in relation to the SF-36 domain of physical functioning (active patients: 87.1 (20.9) vs. inactive patients 80.1 (20.5) inactive; p=0.016), and global functioning when compared to the physically inactive group (active patients: 71.5 (17.6) vs. inactive patients 60.1 (20.9); p=0.011). CONCLUSION: Higher levels of physical activity are associated with better quality of life and higher global functioning in patients in early stages of psychosis.


Assuntos
Transtorno Bipolar/fisiopatologia , Depressão/fisiopatologia , Exercício Físico , Qualidade de Vida , Esquizofrenia/fisiopatologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino
16.
PLoS One ; 15(12): e0243972, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33320913

RESUMO

OBJECTIVES: To evaluate if depression contributes, independently and/or in interaction with frailty, to loss of independence in instrumental activities of daily living (ADL) in older adults with frailty. METHODS: Longitudinal cohort study of people aged ≥75 years living in the community. We used multi-level linear regression model to quantify the relationship between depression (≥5 Geriatric Depression Scale) and frailty (electronic frailty index), and instrumental activities of daily living (Nottingham Extended Activities of Daily Living scale; range: 0-66; higher score implies greater independence). The model was adjusted for known confounders (age; gender; ethnicity; education; living situation; medical comorbidity). RESULTS: 553 participants were included at baseline; 53% were female with a mean age of 81 (5.0 SD) years. Depression and frailty (moderate and severe levels) were independently associated with reduced instrumental activities of daily living scores. In the adjusted analysis, the regression coefficient was -6.4 (95% CI: -8.3 to -4.5, p<0.05) for depression, -1.5 (95% CI: -3.8 to 0.9, p = 0.22) for mild frailty, -6.1 (95% CI: -8.6 to -3.6, p<0.05) for moderate frailty, and -10.1 (95% CI: -13.5 to -6.8, p<0.05) for severe frailty. Moreover, depression interacted with frailty to further reduce instrumental activities of daily living score in individuals with mild or moderate frailty. These relationships remained significant after adjusting for confounders. CONCLUSION: Frailty and depression are independently associated with reduced independence in instrumental activities of daily living. Also, depression interacts with frailty to further reduce independence for mild to moderately frail individuals, suggesting that clinical management of frailty should integrate physical and mental health care.


Assuntos
Atividades Cotidianas , Depressão/diagnóstico , Idoso Fragilizado , Fragilidade/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Depressão/epidemiologia , Depressão/fisiopatologia , Feminino , Fragilidade/epidemiologia , Fragilidade/fisiopatologia , Avaliação Geriátrica , Humanos , Vida Independente , Estudos Longitudinais , Masculino
17.
J Occup Health ; 62(1): e12175, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33131192

RESUMO

OBJECTIVES: The SARS-CoV-2 global pandemic has subjected healthcare workers (HCWs) to high risk of infection through direct workplace exposure, coupled with increased workload and psychological stress. This review aims to determine the impact of SARS-CoV-2 on mental health outcomes of hospital-based HCWs and formulate recommendations for future action. METHODS: A systematic review was performed between 31st December 2019 and 17th June 2020 through Ovid Medline and Embase databases (PROSPERO ID CRD42020181204). Studies were included for review if they investigated the impact of SARS-CoV-2 on mental health outcomes of hospital-based HCWs and used validated psychiatric scoring tools. Prevalence of ICD-10 classified psychiatric disorders was the primary outcome measure. RESULTS: The initial search returned 436 articles. Forty-four studies were included in final analysis, with a total of 69,499 subjects. Prevalence ranges of six mental health outcomes were identified: depression 13.5%-44.7%; anxiety 12.3%-35.6%; acute stress reaction 5.2%-32.9%; post-traumatic stress disorder 7.4%-37.4%; insomnia 33.8%-36.1%; and occupational burnout 3.1%-43.0%. Direct exposure to SARS-CoV-2 patients was the most common risk factor identified for all mental health outcomes except occupational burnout. Nurses, frontline HCWs, and HCWs with low social support and fewer years of working experience reported the worst outcomes. CONCLUSION: The SARS-CoV-2 pandemic has significantly impacted the mental health of HCWs. Frontline staff demonstrate worse mental health outcomes. Hospitals should be staffed to meet service provision requirements and to mitigate the impact onmental health. This can be improved with access to rapid-response psychiatric teams and should be continually monitored throughout the pandemic and beyond its conclusion.


Assuntos
Esgotamento Profissional/epidemiologia , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/psicologia , Saúde do Trabalhador , Estresse Ocupacional/epidemiologia , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Infecções por Coronavirus/prevenção & controle , Depressão/epidemiologia , Depressão/fisiopatologia , Feminino , Humanos , Masculino , Saúde Mental , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Prevalência , Medição de Risco , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Estados Unidos
18.
Maturitas ; 141: 1-8, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33036697

RESUMO

OBJECTIVE: Our study aims to investigate the differences in insomnia between Chinese and Western women during menopause to fill the gaps in the research on menopause in Chinese women, and to examine the premenopausal factors predictive of moderate to severe insomnia during menopause. STUDY DESIGN: This is a longitudinal cohort study conducted in an urban Chinese community with a total of 458 participants. MAIN OUTCOME MEASURES: Presence of insomnia symptoms (trouble falling asleep, waking up early); vasomotor symptoms; anxiety and depression assessed by the Hospital Anxiety and Depression Scale; and menopausal stages. RESULTS: Multivariable analysis showed that compared with that in premenopause, the prevalence of trouble falling asleep was significantly higher in menopausal transition (P = 0.029) and postmenopause (P < 0.001), and the prevalence of early-morning awakenings also significantly increased in menopausal transition (P = 0.003) and postmenopause (P = 0.011). In multivariable analysis anxiety (P = 0.022) and depression (P = 0.005) were independently and significantly positively associated with trouble falling asleep. Anxiety (P < 0.001), depression (P = 0.018), and levels of follicle stimulating hormone (P-0.031) were independently and significantly positively associated with trouble falling asleep. Women who experienced insomnia in premenopause had a significantly higher risk of moderate to severe insomnia in menopausal transition (P = 0.003) and postmenopause (P = 0.047) than those who did not. CONCLUSION: This study showed that the prevalence of sleep disturbance significantly increased during and after menopause. Women with anxiety and depression had a higher risk of insomnia. Difficulty in sleep initiation in the premenopausal period was a strong predictor of moderate to severe insomnia at menopausal transition and postmenopause.


Assuntos
Ansiedade/fisiopatologia , Depressão/fisiopatologia , Menopausa/psicologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Sono , Adulto , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Estudos de Coortes , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Estudos Longitudinais , Menopausa/fisiologia , Pessoa de Meia-Idade , Perimenopausa , Pós-Menopausa , Pré-Menopausa , Prevalência , Fatores de Risco , Transtornos do Sono-Vigília
19.
Epilepsy Behav ; 112: 107396, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32911299

RESUMO

BACKGROUND: The aim of this study was to have a better understanding of the influence of the coronavirus disease 2019 (COVID-19) pandemic in people with epilepsy (PWE) and to assess whether there have been changes in seizure control during the current COVID-19 outbreak, exploring the possible causes thereof. METHODS: This is an observational, retrospective study based on prospective data collection of 100 successive patients who attended an epilepsy outpatient clinic either face-to-face or telephonically during the months of the COVID-19 outbreak and national state of emergency. RESULTS: One hundred patients were included, 52% women, mean age 42.4 years. During the COVID-19 period, 27% of the patients presented an increase of >50% of seizure frequency. An increase of stress/anxiety (odds ratios (OR): 5.78; p = 0.008) and a prior higher seizure frequency (OR: 12.4; p = 0.001) were associated with worsening of seizures. Other risk factors were exacerbation of depression, sleep deprivation, less physical activity, and history of epilepsy surgery. Three patients had status epilepticus (SE) and one a cluster of seizures. Likewise, 9% of patients improved their seizure control. Reduction in stress/anxiety (OR: 0.05; p = 0.03) and recent adjustment of antiepileptics (OR: 0.07; p = 0.01) acted as protecting factors. CONCLUSIONS: A high proportion of PWE suffered a significant worsening of their seizure control during the months of the COVID-19 pandemic. Emotional distress due to home confinement was the main factor for the change in seizure control. Promoting physical activity and adequate sleep may minimize the potential impact of the pandemic in PWE. Ensuring correct follow-up can prevent decompensation in those PWE at high risk.


Assuntos
Anticonvulsivantes/uso terapêutico , Ansiedade/fisiopatologia , Infecções por Coronavirus , Epilepsia/fisiopatologia , Pandemias , Pneumonia Viral , Estresse Psicológico/fisiopatologia , Adolescente , Adulto , Ansiedade/psicologia , Betacoronavirus , Depressão/fisiopatologia , Depressão/psicologia , Progressão da Doença , Epilepsia/tratamento farmacológico , Epilepsia/psicologia , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Convulsões/fisiopatologia , Privação do Sono/fisiopatologia , Espanha , Estado Epiléptico/fisiopatologia , Estresse Psicológico/psicologia
20.
PLoS One ; 15(9): e0238457, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32911486

RESUMO

Anxiety and depression are common among patients with chronic physical illnesses and have a significant impact on morbidity, quality of life, and health service utilisation. Psychological treatment of anxiety and depression has small to moderate efficacy in this group and is not commonly based on a model of causal mechanisms. A novel approach to understanding and improving mental health outcomes in physical illnesses is needed. One approach may be to explore the role of metacognitive beliefs which are reliably associated with anxiety and depression in individuals with mental health difficulties. The current systematic review aimed to evaluate the contribution of metacognitive beliefs to anxiety and depression across physical illnesses. Systematic searches were conducted on Web of Science, PsychINFO, MEDLINE, Embase, and CINAHL of studies published between 1997 and January 2019. 13 eligible studies were identified that in sum comprised 2851 participants. Metacognitive beliefs were found to have reliable, moderate, positive and significant associations with anxiety and depression symptoms across a range of physical illnesses. There appeared to be commonality and some specificity in the relationships. Negative metacognitive beliefs concerned with uncontrollability and danger of worry were associated with both anxiety and depression across all physical illnesses assessed, whilst more specific associations emerged for individual medical conditions where positive beliefs about worry, cognitive confidence and cognitive self-consciousness were unique correlates. Negative metacognitive beliefs of uncontrollability and danger significantly and positively predicted symptoms of anxiety and depression after controlling for factors including age, gender, disease factors and cognition (illness perceptions and intolerance of uncertainty). The results suggest that the metacognitive model of psychological disorder is applicable to psychological symptoms of anxiety and depression across a range of chronic medical conditions, implying that metacognitive therapy might be helpful in improving outcomes in multiple morbidities that involve poor mental and medical health.


Assuntos
Metacognição/fisiologia , Aptidão Física/psicologia , Adulto , Ansiedade/fisiopatologia , Ansiedade/psicologia , Cognição , Depressão/fisiopatologia , Depressão/psicologia , Emoções , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Modelos Psicológicos , Qualidade de Vida , Inquéritos e Questionários
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