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1.
Artigo em Inglês | MEDLINE | ID: mdl-33557142

RESUMO

The COVID-19 pandemic disrupted food systems and the economy in the U.S. and abroad. This cross-sectional study examined the direct and indirect impacts of COVID-19 on food access among low-income and Black, Indigenous, and people of color (BIPOC) in New York State. New York residents were recruited to complete a web-based survey through Qualtrics. The survey took place in May and June 2020 and asked participants about COVID-19 health impacts, risk factors, and food access. Chi-square analysis examined issues with food access experienced by demographic characteristics, work disruptions, health impacts, and household risk for contracting the virus and experiencing severe illness, and significant results were analyzed in a series of logistic regression models. After accounting for covariates, Hispanic respondents, those with likely Major Depressive Disorder, and essential workers were more likely to experience worse food access during COVID-19. Improved policies and services to address impacts on vulnerable populations such as BIPOC, those suffering from mental health disorders, and workers in lower-paying essential jobs can reduce the risk of food access issues at this time. Future research can identify how food access issues during the pandemic influenced diet quality, chronic disease risk and infection, and persistence of food access issues.


Assuntos
Emprego , Pandemias , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Grupos Étnicos , Hispano-Americanos/estatística & dados numéricos , Humanos , Modelos Logísticos , New York/epidemiologia , Ocupações/classificação , Pobreza , Fatores de Risco , Inquéritos e Questionários
2.
PLoS One ; 16(2): e0246602, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33544761

RESUMO

BACKGROUND: Healthcare workers are at increased risk of adverse mental health outcomes during the COVID-19 pandemic. Studies are warranted that examine socio-ecological factors associated with these outcomes to inform interventions that support healthcare workers during future disease outbreaks. METHODS: We conducted an online cross-sectional study of healthcare workers during May 2020 to assess the socio-ecological predictors of mental health outcomes during the COVID-19 pandemic. We assessed factors at four socio-ecological levels: individual (e.g., gender), interpersonal (e.g., social support), institutional (e.g., personal protective equipment availability), and community (e.g., healthcare worker stigma). The Personal Health Questionnaire-9, Generalized Anxiety Disorder-7, Primary Care Post-Traumatic Stress Disorder, and Alcohol Use Disorders Identification Test-Concise scales assessed probable major depression (MD), generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and alcohol use disorder (AUD), respectively. Multivariable logistic regression models were used to assess unadjusted and adjusted associations between socio-ecological factors and mental health outcomes. RESULTS: Of the 1,092 participants, 72.0% were female, 51.9% were frontline workers, and the mean age was 40.4 years (standard deviation = 11.5). Based on cut-off scores, 13.9%, 15.6%, 22.8%, and 42.8% had probable MD, GAD, PTSD, and AUD, respectively. In the multivariable adjusted models, needing more social support was associated with significantly higher odds of probable MD, GAD, PTSD, and AUD. The significance of other factors varied across the outcomes. For example, at the individual level, female gender was associated with probable PTSD. At the institutional level, lower team cohesion was associated with probable PTSD, and difficulty following hospital policies with probable MD. At the community level, higher healthcare worker stigma was associated with probable PTSD and AUD, decreased satisfaction with the national government response with probable GAD, and higher media exposure with probable GAD and PTSD. CONCLUSIONS: These findings can inform targeted interventions that promote healthcare workers' psychological resilience during disease outbreaks.


Assuntos
Alcoolismo/epidemiologia , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Pessoal de Saúde , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , Alcoolismo/psicologia , Transtornos de Ansiedade/psicologia , Estudos Transversais , Transtorno Depressivo Maior/psicologia , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Pandemias , Resiliência Psicológica , Fatores Socioeconômicos , Transtornos de Estresse Pós-Traumáticos/psicologia , Estados Unidos/epidemiologia
3.
J Urban Health ; 98(1): 13-26, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33420551

RESUMO

It is suggested that the nationwide social distancing due to coronavirus disease 2019 (COVID-19) has adverse mental health consequences despite its necessity. We investigated the associations of social distancing measures with mental health problems. Using national representative sample of 509,062 adults in the USA, we examined the associations of small business closure and reduced urban mobility with generalized anxiety disorder (GAD) and major depression disorder (MDD). Multilevel regression models were fitted with individual, household, and state-level covariates, in addition to state and census-region-level random effects. Living in state with the highest quartile of small business closures was associated with increased prevalence of GAD (OR: 1.06; CI: 1.03-1.11) compared to lowest quartile, but had no association with MDD. Living in the highest quartile of urban mobility was associated with lower prevalence of both GAD (OR: 0.88; CI: 0.85-0.93) and MDD (OR: 0.90; CI: 0.86-0.95) relative to the lowest quartile. Our findings suggest that small business closures and reduced mobility during COVID-19 pandemic were negatively associated with the two mental health outcomes in the USA, despite their important roles in preventing the infection.


Assuntos
Transtornos de Ansiedade/etiologia , Transtorno Depressivo Maior/etiologia , Saúde Mental/estatística & dados numéricos , Empresa de Pequeno Porte/estatística & dados numéricos , Estresse Psicológico/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Prevalência , Estados Unidos/epidemiologia , Adulto Jovem
4.
Curr Probl Cardiol ; 46(4): 100737, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33412349

RESUMO

BACKGROUND: The COVID-19 pandemic's mental health consequences remain unknown. AIM: To assess the mental health status of ambulatory cardiometabolic patients during COVID-19 pandemic lockdown in Spanish speaking Latin American countries. METHODS: Cardiometabolic patients without COVID-19 evidence in 13 Latin American countries answered a survey between June 15th and July 15th, 2020. The Diagnosis Manual of Mental Disorders fifth edition was used to identify the presence of major depressive symptoms. RESULTS: The sample included 4216 patients, 1590 (37.71%; IC95% 36.24-39.19) were considered suffering major depression. Female gender, consuming ≥5 medications day, physical activity <100 minutes weekly, low fruits and vegetables intake, poor treatment adherence, reduced food consumption were independently associated to the presence of major depressive symptoms. CONCLUSIONS: The CorCOVID Latam Psy study showed that one-third of the Latin American Spanish speaking population is suffering from major depressive symptoms during the COVID-19 outbreak.


Assuntos
Doenças Cardiovasculares/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Diabetes Mellitus/epidemiologia , Síndrome Metabólica/epidemiologia , Adulto , Idoso , Doenças Cardiovasculares/psicologia , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/psicologia , Depressão/psicologia , Transtorno Depressivo Maior/psicologia , Diabetes Mellitus/psicologia , Dieta/estatística & dados numéricos , Dislipidemias/epidemiologia , Dislipidemias/psicologia , Ingestão de Alimentos , Exercício Físico/psicologia , Feminino , Frutas , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/psicologia , Humanos , Hipertensão/epidemiologia , Hipertensão/psicologia , América Latina/epidemiologia , Masculino , Saúde Mental , Síndrome Metabólica/psicologia , Pessoa de Meia-Idade , Fatores Sexuais , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/psicologia , Inquéritos e Questionários , Cooperação e Adesão ao Tratamento/psicologia , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Verduras
5.
Adv Exp Med Biol ; 1264: 67-80, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33332004

RESUMO

There is a growing body of evidence pointing to the co-occurrence of cannabis use and depression. There is also some evidence that the use of cannabis may lead to the onset of depression; however, strong evidence points to the inverse association; i.e. that depression may lead to the onset or increase in cannabis use frequency. Observational and epidemiological studies have not indicated a positive long-term effect of cannabis use on the course and outcome of depression. The association between cannabis use and depression may be stronger among men during adolescence and emerging adulthood and stronger in women during midlife. There is an indication for potential genetic correlation contributing to the comorbidity of cannabis dependence and major depression, namely that serotonin (5-HT) may mediate such association and there is also evidence for specific risk alleles for cannabis addiction. There is preclinical evidence that alteration in the endocannabinoid system could potentially benefit patients suffering from depression. However, the issue of using cannabis as an anti-depressant is at an early stage of examination and there is little evidence to support it. Finally, there has been little support to the notion that selective serotonin reuptake inhibitors (SSRIs) may be effective in decreasing depressive symptoms or rates of substance use in adolescents treated for depression and a co-occurring substance use disorder. In conclusion, despite methodological limitations, research in the past decades has broadened our knowledge on the association between cannabis use and depression from epidemiological, neurological, genetic, and pharmacological perspectives.


Assuntos
Cannabis/efeitos adversos , Depressão/induzido quimicamente , Depressão/tratamento farmacológico , Transtorno Depressivo Maior/induzido quimicamente , Transtorno Depressivo Maior/tratamento farmacológico , Comorbidade , Depressão/epidemiologia , Depressão/genética , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/genética , Humanos , Abuso de Maconha/epidemiologia
6.
Hipertens. riesgo vasc ; 37(4): 162-168, oct.-dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-196907

RESUMO

INTRODUCCIÓN: Un tercio de los pacientes hipertensos cursan con depresión mayor, relación que se asocia con peor pronóstico. El objetivo del estudio fue estimar la asociación entre depresión e hipertensión arterial, así como establecer la posible bidireccionalidad de las condiciones. MATERIALES Y MÉTODOS: Estudio de cohorte retrospectivo. Se incluyeron personas entre 18 y 65 años con hipertensión arterial, depresión o uso de medicamentos para su manejo. Para analizar la antecedencia se realizó un modelo de comorbilidad. Se realizó un análisis bivariado y luego una regresión logística multivariada. La asociación se estimó por medio de la prueba de Chi cuadrado y las razones de disparidad u odds ratios crudas y ajustadas a las demás variables incluidas en el análisis. Se utilizó la prueba de Hosmer-Lemeshow para evaluar la bondad del ajuste. Se utilizó SPSS® V.21 como paquete estadístico. RESULTADOS: En el estudio se incluyeron 1.721 personas. La prevalencia de depresión en pacientes con y sin hipertensión fue de 17,4 y 12,6%, respectivamente, con un riesgo de 43% de hipertensión en personas con depresión. En los pacientes con depresión esta antecedió el diagnóstico de hipertensión en el 64,8% de los casos, y en los pacientes hipertensos el 22,2% fue diagnosticado con depresión posteriormente. La asociación entre hipertensión arterial y depresión mayor permaneció significativa luego de realizar el ajuste con los demás factores de riesgo. CONCLUSIONES: La depresión se encontró como un factor de riesgo de hipertensión arterial, con una relación bidireccional de riesgo entre depresión e hipertensión arterial


INTRODUCTION: A third of hypertensive patients have major depression, a relationship that is associated with a worse prognosis. The objective of the study was to estimate the association between depression and high blood pressure, as well as to establish the possible bidirectionality of the conditions. MATERIALS AND METHODS: Retrospective cohort study. People between 18 and 65 years old with high blood pressure, depression or use of medications for their management were included. To analyze the antecedent, a comorbidity model was performed. A bivariate analysis was performed and then a multivariate logistic regression. The association was estimated using the Chi-square test and the odds ratios that were crude and adjusted to the other variables included in the analysis. The Hosmer-Lemeshow test was used to assess the goodness of fit. SPSS® V.21 was used as the statistical package. RESULTS: A total of 1,721 people were included in the study. The prevalence of depression in patients with and without hypertension was 17.4 and 12.6%, respectively, with a 43% risk of hypertension in people with depression. In patients with depression, it preceded the diagnosis of hypertension in 64.8% of cases and in hypertensive patients, 22.2% were later diagnosed with depression. The association between high blood pressure and major depression remained significant after adjusting for the other risk factors. CONCLUSIONS: Depression was found as a risk factor for high blood pressure, with a 2-way risk relationship between depression and high blood pressure


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Transtorno Depressivo Maior/epidemiologia , Hipertensão/epidemiologia , Estudos de Coortes , Estudos Retrospectivos , Hipertensão/diagnóstico , Fatores de Risco , Colômbia/epidemiologia , Atividade Motora , Modelos Logísticos
7.
Artigo em Inglês | MEDLINE | ID: mdl-33202706

RESUMO

The novel coronavirus disease 2019 (COVID-19) pandemic brought about several features that increased the sense of fear and confusion, such as quarantine and financial losses among other stressors, which may have led to adverse psychosocial outcomes. The influence of such stressors took place within a broader sociocultural context that needs to be considered. The objective was to examine how the psychological response to the pandemic varied across countries and identify which risk/protective factors contributed to this response. An online survey was conducted from 29 May 2020-12 June 2020, among a multinational sample of 8806 adults from eight countries/regions (Canada, United States, England, Switzerland, Belgium, Hong Kong, Philippines, New Zealand). Probable generalized anxiety disorder (GAD) and major depression episode (MDE) were assessed. The independent role of a wide range of potential factors was examined using multilevel logistic regression. Probable GAD and MDE were indicated by 21.0% and 25.5% of the respondents, respectively, with an important variation according to countries/regions (GAD: 12.2-31.0%; MDE: 16.7-32.9%). When considered together, 30.2% of the participants indicated probable GAD or MDE. Several factors were positively associated with a probable GAD or MDE, including (in descending order of importance) weak sense of coherence (SOC), lower age, false beliefs, isolation, threat perceived for oneself/family, mistrust in authorities, stigma, threat perceived for country/world, financial losses, being a female, and having a high level of information about COVID-19. Having a weak SOC yielded the highest adjusted odds ratio for probable GAD or MDE (3.21; 95% confidence interval (CI): 2.73-3.77). This pandemic is having an impact on psychological health. In some places and under certain circumstances, however, people seem to be better protected psychologically. This is a unique opportunity to evaluate the psychosocial impacts across various sociocultural backgrounds, providing important lessons that could inform all phases of disaster risk management.


Assuntos
Transtornos de Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Transtorno Depressivo Maior/epidemiologia , Pneumonia Viral/psicologia , Adolescente , Adulto , Idoso , Bélgica , Betacoronavirus , Canadá , Estudos Transversais , Inglaterra , Feminino , Hong Kong , Humanos , Masculino , Cura Mental , Pessoa de Meia-Idade , Nova Zelândia , Pandemias , Filipinas , Estresse Psicológico , Suíça , Estados Unidos , Adulto Jovem
8.
J Med Life ; 13(3): 300-305, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33072200

RESUMO

Cyprus has been affected by COVID-19 since March 2019. With a case fatality rate of 2.6% (until June 2020) and the social isolation measures enforced on the population, the population's mental health has been affected. We aimed to assess the mental health burden of the Cypriot population during the outbreak and to explore the potential influence factors. Using a web-based cross-sectional survey, we collected data from 216 volunteers regarding demographic data, COVID-19-related knowledge, generalized anxiety disorder (GAD), and major depressive symptoms. The overall prevalence of GAD and major depressive symptoms of the public were 13.89% and 8.33%, respectively. No demographic had shown any statistical significance with GAD. The younger age group of the study showed a statistically significant association with major depressive symptoms when compared to the adult population in both univariate and multivariable analyses. Our study identified a mental health burden of the Cypriot population, especially the younger age groups. As part of the preparedness for situations as the one we are experiencing and the future impact the pandemic may have on society, interventions should be focused on vulnerable groups of the population to alleviate the psychosocial effects.


Assuntos
Transtornos de Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Transtorno Depressivo Maior/epidemiologia , Pneumonia Viral/psicologia , Adulto , Idoso , Betacoronavirus/fisiologia , Informação de Saúde ao Consumidor , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Chipre/epidemiologia , Feminino , Humanos , Internet , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Prevalência , Inquéritos e Questionários
9.
Niger J Clin Pract ; 23(10): 1431-1436, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33047702

RESUMO

Background: Diabetes mellitus (DM) and depression are common chronic disease states of public health importance with huge burden and the potential to impact many aspects of life. They are said to be related though this relationship is not fully understood. The presence of depression among patients with DM is associated with poor glycemic control, complications, and poor self-care. Method: This was a descriptive cross-sectional study conducted at the Diabetes Clinic of the Jos University Teaching Hospital. Three hundred and ten (310) patients with diabetes mellitus were recruited consecutively. The depression module of the Mini International Neuropsychiatric Interview (M.I.N.I.) version 5.0 was used to ascertain depression among these patients. Other demographic data were obtained using a questionnaire. Blood pressure, weight, and height were also measured and the body mass index (BMI) calculated. Results: One hundred and eighty four (59.35%) of the study population were females and the mean age (SD) of the study population was 54 ± 12 years. The mean age (SD) of the females was 53 ± 11 years and that of the males was 54 ± 12 years with no significant statistical difference (P = 0.35). Two hundred and forty nine (80.32%) of the study population were urban dwellers with 140 (45.16%) earning less than N500, 000 (794 USD) yearly. Current major depression was found in 35 (11.3%) patients, among whom 7 (2.3%) had recurrent depression. The presence of DM complications (OR: 3.50, 95% CI 1.16-10.61) and a positive family history of depression (OR: 4.03, 95% CI 1.32-12.29) were found to be correlates of current major depression. Conclusion: The prevalence of current major depression among patients with diabetes mellitus in this study is high. We recommend that all patients with DM should be screened for depression and treated appropriately to reduce its consequences.


Assuntos
Depressão/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Complicações do Diabetes/epidemiologia , Diabetes Mellitus/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Peso Corporal , Estudos Transversais , Transtorno Depressivo Maior/psicologia , Diabetes Mellitus/sangue , Diabetes Mellitus/psicologia , Feminino , Hemoglobina A Glicada/análise , Hospitais de Ensino , Humanos , Hiperglicemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Autocuidado , Inquéritos e Questionários
10.
Artigo em Inglês | MEDLINE | ID: mdl-32987764

RESUMO

Background: This cross-sectional online survey investigates the prevalence of obsessive-compulsive disorder (OCD) symptoms at an early stage of the COVID-19 pandemic in Canada. Methods: OCD symptoms, moderate/high stress, likely generalized anxiety disorder (GAD) and likely major depressive disorder (MDD) were assessed with the Brief Obsessive-Compulsive Scale (BOCS), Perceived Stress Scale (PSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9) scale, respectively. Results: Out of 32,805 individuals subscribed to Text4Hope, 6041 completed an online survey; the response rate was 18.4%. Overall, 60.3% of respondents reported onset of OCD symptoms and 53.8% had compulsions to wash hands during the COVID-19 pandemic. Respondents who showed OCD symptoms only since the start of COVID-19 were significantly more likely to have moderate/high stress (z = 6.4, p < 0.001), likely GAD (z = 6.0, p < 0.001), and likely MDD (z = 2.7, p < 0.01). Similarly, respondents who engaged in compulsive hand washing were significantly more likely to have moderate/high stress (z = 4.6, p < 0.001) and likely GAD (z = 4.6 p < 0.001), but not likely MDD (z = 1.4, p = 0.16). Conclusion: The prevalence of OCD symptoms increased during the COVID-19 pandemic, at a rate significantly higher than pre-pandemic rates reported for the sample population. Presenting with OCD symptoms increased the likelihood of presenting with elevated stress, likely GAD, and likely MDD.


Assuntos
Transtornos de Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Transtorno Depressivo Maior/epidemiologia , Saúde Mental , Transtorno Obsessivo-Compulsivo/epidemiologia , Pneumonia Viral/psicologia , Betacoronavirus , Canadá/epidemiologia , Estudos Transversais , Humanos , Pandemias , Prevalência , Estresse Psicológico/epidemiologia
11.
Epidemiol Psychiatr Sci ; 29: e173, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32988427

RESUMO

AIMS: The United Nations warned of COVID-19-related mental health crisis; however, it is unknown whether there is an increase in the prevalence of mental disorders as existing studies lack a reliable baseline analysis or they did not use a diagnostic measure. We aimed to analyse trends in the prevalence of mental disorders prior to and during the COVID-19 pandemic. METHODS: We analysed data from repeated cross-sectional surveys on a representative sample of non-institutionalised Czech adults (18+ years) from both November 2017 (n = 3306; 54% females) and May 2020 (n = 3021; 52% females). We used Mini International Neuropsychiatric Interview (MINI) as the main screening instrument. We calculated descriptive statistics and compared the prevalence of current mood and anxiety disorders, suicide risk and alcohol-related disorders at baseline and right after the first peak of COVID-19 when related lockdown was still in place in CZ. In addition, using logistic regression, we assessed the association between COVID-19-related worries and the presence of mental disorders. RESULTS: The prevalence of those experiencing symptoms of at least one current mental disorder rose from a baseline of 20.02 (95% CI = 18.64; 21.39) in 2017 to 29.63 (95% CI = 27.9; 31.37) in 2020 during the COVID-19 pandemic. The prevalence of both major depressive disorder (3.96, 95% CI = 3.28; 4.62 v. 11.77, 95% CI = 10.56; 12.99); and suicide risk (3.88, 95% CI = 3.21; 4.52 v. 11.88, 95% CI = 10.64; 13.07) tripled and current anxiety disorders almost doubled (7.79, 95% CI = 6.87; 8.7 v. 12.84, 95% CI = 11.6; 14.05). The prevalence of alcohol use disorders in 2020 was approximately the same as in 2017 (10.84, 95% CI = 9.78; 11.89 v. 9.88, 95% CI = 8.74; 10.98); however, there was a significant increase in weekly binge drinking behaviours (4.07% v. 6.39%). Strong worries about both, health or economic consequences of COVID-19, were associated with an increased odds of having a mental disorder (1.63, 95% CI = 1.4; 1.89 and 1.42, 95% CI = 1.23; 1.63 respectively). CONCLUSIONS: This study provides evidence matching concerns that COVID-19-related mental health problems pose a major threat to populations, particularly considering the barriers in service provision posed during lockdown. This finding emphasises an urgent need to scale up mental health promotion and prevention globally.


Assuntos
Infecções por Coronavirus/psicologia , Transtornos Mentais/epidemiologia , Saúde Mental/estatística & dados numéricos , Pneumonia Viral/psicologia , Adulto , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtornos Relacionados ao Uso de Álcool/etiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Estudos Transversais , República Tcheca/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/etiologia , Feminino , Humanos , Masculino , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Pandemias , Pneumonia Viral/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Suicídio/estatística & dados numéricos , Inquéritos e Questionários
12.
PLoS One ; 15(9): e0238843, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915863

RESUMO

OBJECTIVE: The economic burden of commercially insured patients in the United States with treatment-resistant depression and patients with non-treatment-resistant major depressive disorder was compared using data from the Optum Clinformatics™ claims database. METHODS: Patients 18-63 years on antidepressant treatment between 1/1/13 and 9/30/13, who had no treatment claims for depression 6 months before the index date (first antidepressant dispensing), and who had a major depressive disorder or depression diagnosis within 30 days of the index date, were included. Treatment-resistant depression was defined as receiving 3 antidepressant regimens during 1 major depressive disorder episode. Patients with treatment-resistant depression were matched with patients with non-treatment-resistant major depressive disorder at a 1:4 ratio using propensity score matching. The study consisted of 1-year baseline (pre-index) and 2-year follow-up (post index) periods. Cost outcomes were compared using a generalized linear model. RESULTS: 2,370 treatment-resistant depression and 9,289 non-treatment-resistant major depressive disorder patients were included. In year 1 of the follow-up period, compared with non-treatment-resistant major depressive disorder, patients with treatment-resistant depression had: more emergency department visits (odds ratio = 1.39, 95% confidence interval = 1.24-1.56); more inpatient hospitalizations (odds ratio = 1.73, 95% confidence interval = 1.46-2.05); longer hospital stays (mean difference vs non-treatment-resistant major depressive disorder = 2.86, 95% confidence interval = 0.86-4.86 days); and more total healthcare costs (mean difference vs non-treatment-resistant major depressive disorder = US$3,846, 95% confidence interval = $2,855-$4,928). These patterns remained consistent in year 2 of the follow-up period. CONCLUSION: Treatment-resistant depression was associated with higher healthcare resource utilization and costs versus non-treatment-resistant major depressive disorder in this commercially insured cohort of patients in the United States.


Assuntos
Antidepressivos/economia , Assistência à Saúde/estatística & dados numéricos , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Custos de Cuidados de Saúde , Recursos em Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Antidepressivos/uso terapêutico , Bases de Dados Factuais , Assistência à Saúde/economia , Transtorno Depressivo Maior/economia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Resistente a Tratamento/economia , Transtorno Depressivo Resistente a Tratamento/epidemiologia , Feminino , Humanos , Revisão da Utilização de Seguros , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Estados Unidos/epidemiologia , Adulto Jovem
13.
Brain Behav Immun ; 89: 594-600, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32738287

RESUMO

Infection-triggered perturbation of the immune system could induce psychopathology, and psychiatric sequelae were observed after previous coronavirus outbreaks. The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. We investigated the psychopathological impact of COVID-19 in survivors, also considering the effect of clinical and inflammatory predictors. We screened for psychiatric symptoms 402 adults surviving COVID-19 (265 male, mean age 58), at one month follow-up after hospital treatment. A clinical interview and a battery of self-report questionnaires were used to investigate post-traumatic stress disorder (PTSD), depression, anxiety, insomnia, and obsessive-compulsive (OC) symptomatology. We collected sociodemographic information, clinical data, baseline inflammatory markers and follow-up oxygen saturation levels. A significant proportion of patients self-rated in the psychopathological range: 28% for PTSD, 31% for depression, 42% for anxiety, 20% for OC symptoms, and 40% for insomnia. Overall, 56% scored in the pathological range in at least one clinical dimension. Despite significantly lower levels of baseline inflammatory markers, females suffered more for both anxiety and depression. Patients with a positive previous psychiatric diagnosis showed increased scores on most psychopathological measures, with similar baseline inflammation. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, positively associated with scores of depression and anxiety at follow-up. PTSD, major depression, and anxiety, are all high-burden non-communicable conditions associated with years of life lived with disability. Considering the alarming impact of COVID-19 infection on mental health, the current insights on inflammation in psychiatry, and the present observation of worse inflammation leading to worse depression, we recommend to assess psychopathology of COVID-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.


Assuntos
Transtornos de Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Pneumonia Viral/epidemiologia , Sobreviventes/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/imunologia , Ansiedade/psicologia , Transtornos de Ansiedade/imunologia , Transtornos de Ansiedade/psicologia , Betacoronavirus , Proteína C-Reativa/imunologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Depressão/imunologia , Depressão/psicologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/imunologia , Transtorno Depressivo/psicologia , Transtorno Depressivo Maior/imunologia , Transtorno Depressivo Maior/psicologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Inflamação , Itália/epidemiologia , Tempo de Internação/estatística & dados numéricos , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/imunologia , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Monócitos , Neutrófilos , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/imunologia , Transtorno Obsessivo-Compulsivo/psicologia , Pandemias , Pneumonia Viral/imunologia , Pneumonia Viral/psicologia , Índice de Gravidade de Doença , Fatores Sexuais , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/imunologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia
14.
Lancet Psychiatry ; 7(9): 801-812, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32828168

RESUMO

Persistent depressive disorder is a chronic mood disorder that is common and often more disabling than episodic major depression. In DSM-5, the term subsumes several chronic depressive presentations, including dysthymia with or without superimposed major depressive episodes, chronic major depression, and recurrent major depression without recovery between episodes. Dysthymia can be difficult to detect in psychiatric and primary care settings until it intensifies in the form of a superimposed major depressive episode. Although information is scarce concerning the cause of persistent depressive disorder including dysthymia, the causation is likely to be multifactorial. In this narrative Review, we discuss current knowledge about the nosology and neurobiological basis of dysthymia and persistent depressive disorder, emphasising a dimensional perspective based on course for further research. We also review new developments in psychotherapy and pharmacotherapy for persistent depressive disorder, and propose a tailored, modular approach to accommodate its multifaceted nature.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/terapia , Transtorno Distímico/diagnóstico , Transtorno Distímico/terapia , Antidepressivos/uso terapêutico , Doença Crônica , Terapia Combinada , Comorbidade , Transtorno Depressivo Maior/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtorno Distímico/epidemiologia , Humanos , Psicoterapia/métodos , Recidiva
15.
Neurology ; 95(14): e1963-e1970, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-32817390

RESUMO

OBJECTIVE: To explore the causal relationships between sleep, major depressive disorder (MDD), and Alzheimer disease (AD). METHODS: We conducted bidirectional 2-sample Mendelian randomization analyses. Genetic associations were obtained from the largest genome-wide association studies currently available in UK Biobank (n = 446,118), Psychiatric Genomics Consortium (n = 18,759), and International Genomics of Alzheimer's Project (n = 63,926). We used the inverse variance-weighted Mendelian randomization method to estimate causal effects and weighted median and Mendelian randomization-Egger for sensitivity analyses to test for pleiotropic effects. RESULTS: We found that higher risk of AD was significantly associated with being a "morning person" (odds ratio [OR] 1.01, p = 0.001), shorter sleep duration (self-reported: ß = -0.006, p = 1.9 × 10-4; accelerometer based: ß = -0.015, p = 6.9 × 10-5), less likely to report long sleep (ß = -0.003, p = 7.3 × 10-7), earlier timing of the least active 5 hours (ß = -0.024, p = 1.7 × 10-13), and a smaller number of sleep episodes (ß = -0.025, p = 5.7 × 10-14) after adjustment for multiple comparisons. We also found that higher risk of AD was associated with lower risk of insomnia (OR 0.99, p = 7 × 10-13). However, we did not find evidence that these abnormal sleep patterns were causally related to AD or for a significant causal relationship between MDD and risk of AD. CONCLUSION: We found that AD may causally influence sleep patterns. However, we did not find evidence supporting a causal role of disturbed sleep patterns for AD or evidence for a causal relationship between MDD and AD.


Assuntos
Doença de Alzheimer/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Sono , Doença de Alzheimer/genética , Transtorno Depressivo Maior/genética , Feminino , Estudo de Associação Genômica Ampla , Humanos , Masculino , Análise da Randomização Mendeliana , Fenótipo , Sono/genética
16.
Obstet Gynecol ; 136(3): 613-621, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32769639

RESUMO

OBJECTIVE: To estimate the effect of an interpersonal therapy-based intervention on reducing the risk of postpartum depression in adolescents. METHODS: A randomized controlled trial enrolled 250 pregnant adolescents who were aged 18 years or younger at conception. The initial sample size calculation estimated 276 participants (324 with attrition) were needed to detect a 50% reduction in risk of the primary outcome, postpartum major depressive episode, with an alpha of 0.05% and 80% power. An interim analysis by the Data Safety and Monitoring Committee informed a revision in the sample size target to 250. Participants were randomized to the intervention (n=129) or a time-matched control group (n=121) who attended sessions about pregnancy topics. Each group received five prenatal sessions and a postpartum booster session. A structured diagnostic interview was administered at baseline and specific time points through 12-months postpartum to assess for major depressive episode onset. RESULTS: Participants were recruited from December 2011 to May 2016 through urban prenatal care sites in the state of Rhode Island. Of the 250 participants, 58% identified as Hispanic and 20% as black or African American. The rate of major depressive episode by 12 months postpartum was 7.0% (95% CI 2.3-11.7%) in the control group and 7.6% (95% CI 2.5-12.7%) in the intervention group, with no significant difference between groups at any time point (P=.88 by log-rank test). CONCLUSION: No benefit was shown between the intervention and control groups in the rates of major depressive episode, which is likely related to a lower than predicted rate of this outcome in the control group (7.6% actual vs 25% predicted). Enhanced local community resources available to pregnant and parenting adolescents during the study period may be an explanation for this result. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01482832.


Assuntos
Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/terapia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/terapia , Psicoterapia Interpessoal , Adolescente , Criança , Feminino , Humanos , Medição de Risco , Método Simples-Cego
17.
Braz J Psychiatry ; 42(6): 657-672, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756809

RESUMO

OBJECTIVES: Major depressive disorder (MDD) is one of the most disabling mental illnesses and it has a significant impact on society. This review aims to provide updated scientific evidence about the epidemiology of MDD. METHODS: A systematic literature review of the PubMed and MEDLINE databases was performed to identify articles on the prevalence of MDD and its correlates. The search was restricted to manuscripts published between January 2001 and December 2018. RESULTS: Sixty-three articles were included in the review. The lifetime prevalence of MDD ranged from 2 to 21%, with the highest rates found in some European countries and the lowest in some Asian countries. The main sociodemographic correlates were separated/divorced marital status and female gender. Child abuse, intimate partner violence, and comorbidity with other physical and mental disorders also were consistently associated with MDD across the reviewed studies. CONCLUSIONS: MDD is a highly prevalent condition worldwide. There are remarkable interregional differences in the disorder's prevalence, as well as in certain sociodemographic correlates. MDD is also highly comorbid with physical and mental health problems.


Assuntos
Transtorno Depressivo Maior , Criança , Comorbidade , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Estado Civil , Prevalência
18.
Eur J Obstet Gynecol Reprod Biol ; 253: 90-94, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32829231

RESUMO

OBJECTIVE: To explore the impact of the COVID-19 pandemic on the mental health of Obstetricians and Gynaecologists. STUDY DESIGN: A cross-section survey-based study amongst doctors working within Obstetrics and Gynaecology in the United Kingdom. RESULTS: A total of 207 doctors completed the survey. Obstetricians and Gynaecologists reported significantly higher rates of both Major Depressive Disorder (versus, p = 0.023) and Generalised Anxiety Disorder (versus, p = 0.044) as compared to the UK-wide estimates. Sub-group analysis showed that anxiety was more common amongst female doctors as compared to males (versus, p = 0.047). Although the prevalence of GAD was higher amongst registrars compared to their Consultant and/or Senior House Officer counterparts, this was not statistically significant. Respondents felt that the most significant factor for work-related changes to mental health was keeping up to date with frequently changing guidelines and protocols related to COVID-19. Only of respondents felt able to talk to colleagues about their mental health. CONCLUSIONS: Key findings include the high prevalence of mental health conditions amongst doctors, demonstration of the persistent taboo that mental health carries within the speciality and the key contributory factors to poor mental health. Further work should be done to assess if changes to the way new and updating guidelines, protocols and pathways are disseminated reduces the impact on the mental health of doctors. With the threat of a second COVID-19 peak looming, now more than ever, it is vital that steps are taken to break the stigmatisation of mental health amongst doctors, encouraging doctors to seek help when required.


Assuntos
Infecções por Coronavirus/psicologia , Ginecologia/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Obstetrícia/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Médicos/psicologia , Pneumonia Viral/psicologia , Adulto , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Betacoronavirus , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Doenças Profissionais/psicologia , Pandemias , Inquéritos e Questionários , Reino Unido/epidemiologia
19.
PLoS One ; 15(7): e0235409, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726314

RESUMO

OBJECTIVES: To identify inequalities in cancer survival rates for patients with a history of severe psychiatric illness (SPI) compared to those with no history of mental illness and explore differences in the provision of recommended cancer treatment as a potential explanation. DESIGN: Population-based retrospective cohort study using linked cancer registry and administrative data at ICES. SETTING: The universal healthcare system in Ontario, Canada. PARTICIPANTS: Colorectal cancer (CRC) patients diagnosed between April 1st, 2007 and December 31st, 2012. SPI history (schizophrenia, schizoaffective disorders, other psychotic disorders, bipolar disorders or major depressive disorders) was determined using hospitalization, emergency department, and psychiatrist visit data and categorized as 'no history of mental illness, 'outpatient SPI history', and 'inpatient SPI history'. MAIN OUTCOME MEASURES: Cancer-specific survival, non-receipt of surgical resection, and non-receipt of adjuvant chemotherapy or radiation. RESULTS: 24,507 CRC patients were included; 482 (2.0%) had an outpatient SPI history and 258 (1.0%) had an inpatient SPI history. Individuals with an SPI history had significantly lower survival rates and were significantly less likely to receive guideline recommended treatment than CRC patients with no history of mental illness. The adjusted HR for cancer-specific death was 1.69 times higher for individuals with an inpatient SPI (95% CI 1.36-2.09) and 1.24 times higher for individuals with an outpatient SPI history (95% CI 1.04-1.48). Stage II and III CRC patients with an inpatient SPI history were 2.15 times less likely (95% CI 1.07-4.33) to receive potentially curative surgical resection and 2.07 times less likely (95% CI 1.72-2.50) to receive adjuvant radiation or chemotherapy. These findings were consistent across multiple sensitivity analyses. CONCLUSIONS: Individuals with an SPI history experience inequalities in colorectal cancer care and survival within a universal healthcare system. Increasing advocacy and the availability of resources to support individuals with an SPI within the cancer system are warranted to reduce the potential for unnecessary harm.


Assuntos
Transtorno Bipolar/terapia , Neoplasias Colorretais/terapia , Transtorno Depressivo Maior/terapia , Esquizofrenia/terapia , Adulto , Transtorno Bipolar/complicações , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/patologia , Sobreviventes de Câncer/psicologia , Quimioterapia Adjuvante , Estudos de Coortes , Neoplasias Colorretais/complicações , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/patologia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/patologia , Serviço Hospitalar de Emergência , Feminino , Hospitalização , Humanos , Pacientes Internados/psicologia , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Esquizofrenia/complicações , Esquizofrenia/epidemiologia , Esquizofrenia/patologia
20.
BMC Public Health ; 20(1): 1168, 2020 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-32718306

RESUMO

BACKGROUND: Problematic anger is intense anger associated with elevated generalized distress and that interferes with functioning. It also confers a heightened risk for the development of mental health problems. In military personnel and veterans, previous studies examining problematic anger have been constrained by sample size, cross-sectional data, and measurement limitations. METHODS: The current study used Millennium Cohort survey data (N = 90,266) from two time points (2013 and 2016 surveys) to assess the association of baseline demographics, military factors, mental health, positive perspective, and self-mastery, with subsequent problematic anger. RESULTS: Overall, 17.3% of respondents reported problematic anger. In the fully adjusted logistic regression model, greater risk of problematic anger was predicted by certain demographic characteristics as well as childhood trauma and financial problems. Service members who were in the Army or Marines, active duty (vs. reserves/national guard), and previously deployed with high levels of combat had increased risk for problematic anger. Veterans were also more likely to report problematic anger than currently serving personnel. Mental health predictors included posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and comorbid PTSD/MDD. Higher levels of positive perspective and self-mastery were associated with decreased risk of problematic anger. CONCLUSION: Not only did 1 in 6 respondents report problematic anger, but risk factors were significant even after adjusting for PTSD and MDD, suggesting that problematic anger is more than an expression of these mental health problems. Results identify potential targets of early intervention and clinical treatment for addressing problematic anger in the military and veteran context.


Assuntos
Ira , Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Adulto , Estudos de Coortes , Comorbidade , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Militares/estatística & dados numéricos , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Veteranos/estatística & dados numéricos
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