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2.
Cereb Cortex ; 34(7)2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38990517

RESUMO

Aberrations in non-verbal social cognition have been reported to coincide with major depressive disorder. Yet little is known about the role of the eyes. To fill this gap, the present study explores whether and, if so, how reading language of the eyes is altered in depression. For this purpose, patients and person-by-person matched typically developing individuals were administered the Emotions in Masked Faces task and Reading the Mind in the Eyes Test, modified, both of which contained a comparable amount of visual information available. For achieving group homogeneity, we set a focus on females as major depressive disorder displays a gender-specific profile. The findings show that facial masks selectively affect inferring emotions: recognition of sadness and anger are more heavily compromised in major depressive disorder as compared with typically developing controls, whereas the recognition of fear, happiness, and neutral expressions remains unhindered. Disgust, the forgotten emotion of psychiatry, is the least recognizable emotion in both groups. On the Reading the Mind in the Eyes Test patients exhibit lower accuracy on positive expressions than their typically developing peers, but do not differ on negative items. In both depressive and typically developing individuals, the ability to recognize emotions behind a mask and performance on the Reading the Mind in the Eyes Test are linked to each other in processing speed, but not recognition accuracy. The outcome provides a blueprint for understanding the complexities of reading language of the eyes within and beyond the COVID-19 pandemic.


Assuntos
Transtorno Depressivo Maior , Emoções , Expressão Facial , Humanos , Feminino , Adulto , Emoções/fisiologia , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/fisiopatologia , Adulto Jovem , Reconhecimento Facial/fisiologia , Pessoa de Meia-Idade , COVID-19/psicologia , Leitura
3.
BMC Psychiatry ; 24(1): 516, 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39030505

RESUMO

BACKGROUND: Behavioral activation has gained increasing attention as an effective treatment for depression. However, the effectiveness of Behavioral Activation Group Therapy (BAGT) in controlled conditions compared to its self-help programs requires more investigation. The present study aimed to compare their effectiveness on depressive symptoms, repetitive negative thinking (RNT), and performance in patients with major depressive disorder (MDD). METHODS: In this randomized clinical trial, 40 patients diagnosed with Major Depressive Disorder (MDD) were recruited based on a structured clinical interview for DSM-5 (SCID-5). Participants were allocated to BAGT (n = 20) and self-help behavioral activation (SBA; n = 20) groups. BAGT received ten weekly sessions (90 min), while the SBA group followed the same protocol as the self-help intervention. Participants were evaluated at pre-treatment, post-treatment, and the 2-month follow-up using the Beck Depression Inventory-II (BDI-II), repetitive thinking questionnaire (RTQ-31), and work and social adjustment scale (WSAS). RESULTS: The results of a Mixed ANOVA analysis revealed that participants who underwent BAGT showed significant improvement in depression, rumination, work, and social functioning post-treatment and at the 2-month follow-up. However, the SBA group did not show significant changes in any outcome. The study also found that, based on clinical significance, 68% of the BAGT participants were responsive to treatment, and 31% achieved a high final performance status at the 2-month follow-up. DISCUSSION: BAGT was more effective than SBA in MDD patients. Participants' engagement with self-help treatment is discussed. TRIAL REGISTRATION: The present trial has been registered in the Iranian Registry of Clinical Trials Center (IRCT ID: IRCT20181128041782N1|| http://www.irct.ir/ ) (Registration Date: 04/03/2019).


Assuntos
Transtorno Depressivo Maior , Psicoterapia de Grupo , Humanos , Transtorno Depressivo Maior/terapia , Transtorno Depressivo Maior/psicologia , Feminino , Masculino , Adulto , Psicoterapia de Grupo/métodos , Pessoa de Meia-Idade , Resultado do Tratamento , Escalas de Graduação Psiquiátrica , Ruminação Cognitiva/fisiologia , Terapia Comportamental/métodos , Grupos de Autoajuda , Adulto Jovem
4.
Transl Psychiatry ; 14(1): 278, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38969642

RESUMO

Major depressive disorder (MDD) is characterized by a multitude of psychopathological symptoms including affective, cognitive, perceptual, sensorimotor, and social. The neuronal mechanisms underlying such co-occurrence of psychopathological symptoms remain yet unclear. Rather than linking and localizing single psychopathological symptoms to specific regions or networks, this perspective proposes a more global and dynamic topographic approach. We first review recent findings on global brain activity changes during both rest and task states in MDD showing topographic reorganization with a shift from unimodal to transmodal regions. Next, we single out two candidate mechanisms that may underlie and mediate such abnormal uni-/transmodal topography, namely dynamic shifts from shorter to longer timescales and abnormalities in the excitation-inhibition balance. Finally, we show how such topographic shift from unimodal to transmodal regions relates to the various psychopathological symptoms in MDD including their co-occurrence. This amounts to what we describe as 'Topographic dynamic reorganization' which extends our earlier 'Resting state hypothesis of depression' and complements other models of MDD.


Assuntos
Encéfalo , Transtorno Depressivo Maior , Humanos , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Encéfalo/fisiopatologia , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico
5.
Nat Commun ; 15(1): 5528, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39009561

RESUMO

The rewards that we get from our choices and actions can have a major influence on our future behavior. Understanding how reward biasing of behavior is implemented in the brain is important for many reasons, including the fact that diminution in reward biasing is a hallmark of clinical depression. We hypothesized that reward biasing is mediated by the anterior cingulate cortex (ACC), a cortical hub region associated with the integration of reward and executive control and with the etiology of depression. To test this hypothesis, we recorded neural activity during a biased judgment task in patients undergoing intracranial monitoring for either epilepsy or major depressive disorder. We found that beta (12-30 Hz) oscillations in the ACC predicted both associated reward and the size of the choice bias, and also tracked reward receipt, thereby predicting bias on future trials. We found reduced magnitude of bias in depressed patients, in whom the beta-specific effects were correspondingly reduced. Our findings suggest that ACC beta oscillations may orchestrate the learning of reward information to guide adaptive choice, and, more broadly, suggest a potential biomarker for anhedonia and point to future development of interventions to enhance reward impact for therapeutic benefit.


Assuntos
Transtorno Depressivo Maior , Giro do Cíngulo , Recompensa , Humanos , Giro do Cíngulo/fisiologia , Giro do Cíngulo/diagnóstico por imagem , Giro do Cíngulo/fisiopatologia , Masculino , Adulto , Feminino , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Comportamento de Escolha/fisiologia , Pessoa de Meia-Idade , Ritmo beta/fisiologia , Epilepsia/fisiopatologia , Adulto Jovem
6.
Sci Rep ; 14(1): 16264, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39009703

RESUMO

Patients with bipolar disorder (BD) and major depressive disorder (MDD) experience psychological distress associated with daily events that do not meet the threshold for traumatic experiences, referred to as event-related psychological distress (ERPD). Recently, we developed an assessment tool for ERPD, the ERPD-24. This tool considers four factors of ERPD: feelings of revenge, rumination, self-denial, and mental paralysis. We conducted a cross-sectional study between March 2021 and October 2022 to identify the differences and clinical features of ERPD among patients with MDD and BD and healthy subjects who did not experience traumatic events. Specifically, we assessed ERPD using the ERPD-24 and anxiety-related symptoms with the State-Trait Anxiety Inventory, Liebowitz Social Anxiety Scale, and anxious-depressive attack. Regarding the ERPD-24 scores among the groups, as the data did not rigorously follow the test of normality, the Kruskal-Wallis test was used to compare the differences among the groups, followed by the Dunn-Bonferroni adjusted post-hoc test. Non-remitted MDD patients and BD patients, regardless of remission/non-remission, presented more severe ERPD than healthy subjects. This study also demonstrated the relationships between all anxiety-related symptoms, including social phobia and anxious-depressive attack and ERPD, in both BD and MDD patients and in healthy subjects. In conclusion, patients with non-remitted MDD and with BD regardless of remission/non-remission experience severe ERPD related to anxiety-related symptoms.


Assuntos
Transtorno Bipolar , Transtorno Depressivo Maior , Angústia Psicológica , Humanos , Transtorno Bipolar/psicologia , Transtorno Depressivo Maior/psicologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Ansiedade/psicologia , Acontecimentos que Mudam a Vida , Estresse Psicológico/psicologia
7.
J Clin Psychiatry ; 85(3)2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-39028544

RESUMO

Background: Low-dose ketamine infusion has been demonstrated to exert antisuicidal effects on patients with treatment-resistant depression (TRD) and strong suicidal ideation. Although evidence suggests an association between hopelessness and suicidality, very few studies have investigated the antihopelessness effects of ketamine.Methods: This study included 84 patients with TRD and strong suicidal ideation. The diagnosis of depression was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnostic criteria for major depressive disorder. They were randomly assigned to receive a single infusion of either 0.5 mg/kg ketamine or 0.045 mg/kg midazolam. Hopelessness and suicidal symptoms were assessed at baseline, at 240 minutes postinfusion, and on Days 2, 3, 7, and 14 postinfusion. The assessments were performed using the self-report Beck Hopelessness Scale (BHS) and Positive and Negative Suicide Ideation Inventory (PANSI). The analysis focused on the positive and negative domains of the BHS and PANSI, respectively. The clinical trial was conducted between August 15, 2018, and November 30, 2021.Results: Statistical analyses performed using a generalized linear model revealed that the ketamine group had significantly higher PANSI-positive (P = .008) and lower PANSI-negative (P = .015) suicidal ideation scores on Day 2 postinfusion than did the midazolam group. At 240 minutes postinfusion, the ketamine group had significantly lower BHS-negative domain scores than did the midazolam group (P = .031). Notably, the observed ketamine-induced reduction in hopelessness at 240 minutes postinfusion was associated with its antisuicidal effect on Day 2 postinfusion.Discussion: A single infusion of low-dose ketamine resulted in a brief (∼4 hours) yet significant reduction in hopelessness. Subjective antisuicidal effects of ketamine were noted on Day 2 postinfusion. Further studies are needed to elucidate the neuromechanisms underlying the antihopelessness and antisuicidal effects of ketamine.Trial Registration: UMIN Clinical Trials Registry identifiers: UMIN000033916 and UMIN000033760.


Assuntos
Transtorno Depressivo Resistente a Tratamento , Ketamina , Ideação Suicida , Humanos , Ketamina/administração & dosagem , Ketamina/farmacologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Transtorno Depressivo Resistente a Tratamento/psicologia , Infusões Intravenosas , Midazolam/administração & dosagem , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/psicologia , Esperança , Escalas de Graduação Psiquiátrica
8.
J Matern Fetal Neonatal Med ; 37(1): 2356033, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39034157

RESUMO

BACKGROUND: Major Depressive Disorder (MDD) during the perinatal period is a significant global health concern, ranking as the fourth-leading contributor to the global burden of disease and the second-leading cause of disability in individuals aged 15-44. This study investigates the association between perinatal MDD, poor nutrition, low prenatal care adherence, substance use and increased suicide risk. METHODOLOGY: A comprehensive review of existing research studies examined the prevalence and consequences of perinatal MDD. Studies focusing on symptoms, risk factors, and associated outcomes in mothers and infants were analyzed to provide a comprehensive overview of the multifaceted impact of MDD during the perinatal period. CONCLUSION: Approximately 10-15% of women experience postpartum depression, with over 60% reporting symptoms within the first 6 weeks postpartum. Postpartum MDD increases the likelihood of preterm birth, small-for-gestational-age newborns and developmental delay. These findings underscore the critical need for comprehensive screening, identification and intervention approaches to mitigate the short and long term consequences of perinatal MDD.


Assuntos
Depressão Pós-Parto , Transtorno Depressivo Maior , Humanos , Recém-Nascido , Feminino , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/terapia , Depressão Pós-Parto/psicologia , Gravidez , Transtorno Depressivo Maior/terapia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/diagnóstico , Unidades de Terapia Intensiva Neonatal , Pais/psicologia , Prestação Integrada de Cuidados de Saúde
9.
PLoS One ; 19(7): e0306071, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38954722

RESUMO

INTRODUCTION: Depression is a prevalent and debilitating mental illness affecting young women worldwide. This study aimed to identify psychosocial determinants of major depressive disorder (MDD) among young women in Bihar and Uttar Pradesh, India. METHODS: Data from "Understanding the Lives of Adolescents and Young Adults" (UDAYA) study (2018-19) for young women aged 12-23 years, both married and unmarried was used for this paper. MDD was evaluated using the Patient Health Questionnaire PHQ-9 with a cut-off score of ≤10. The determinants of MDD were identified through multilevel binary logistic regression analysis. RESULTS: The prevalence of MDD was 13.6% (95% CL 12.2-15.2) and 5.1% (95% CL 4.2-6.1) for young married women and unmarried girls, respectively. Among the young married women, community-level variables like dowry-related humiliation (1.74, 95% CI 1.15-2.64), and sexual assaults (2.15, 95% CI 1.24-3.73) were significantly associated with MDD. For unmarried girls, reporting of family violence <10% of participants (0.45, 95% CI 0.24-0.85), family violence (≥10% of participants) % (0.35 95% CI 0.19-0.68) and interpartner violence (>25% of participants) (0.42; 95% CI 0.23-0.74) remain significant predictors of MDD. At individual level, for both the groups, age, participation in decision making (on education), social capital (currently attending school/educational course and number of friends), self-efficacy, telephonic harassment, and physical activity were associated with MDD. Wealth index, job seeking, participation in decision making (on health-seeking), parental interactions and physical abuse (for unmarried girls only) and education, reported last sexual intercourse, pressure from the in-laws' to conceive (for young married women only) were associated with MDD. CONCLUSIONS: For young married women, community level targeted interventions should focus on the social ecology to foster a sense of safe community environment. For unmarried girls, additionally, interventions should aim to optimize their family environment for effective mental health outcomes.


Assuntos
Transtorno Depressivo Maior , Casamento , Humanos , Feminino , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Adolescente , Adulto Jovem , Índia/epidemiologia , Prevalência , Casamento/psicologia , Criança , Inquéritos e Questionários , Adulto , Pessoa Solteira/psicologia , Pessoa Solteira/estatística & dados numéricos
10.
CNS Neurosci Ther ; 30(7): e14871, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39037006

RESUMO

MAIN PROBLEM: Anhedonia is a critical diagnostic symptom of major depressive disorder (MDD), being associated with poor prognosis. Understanding the neural mechanisms underlying anhedonia is of great significance for individuals with MDD, and it encourages the search for objective indicators that can reliably identify anhedonia. METHODS: A predictive model used connectome-based predictive modeling (CPM) for anhedonia symptoms was developed by utilizing pre-treatment functional connectivity (FC) data from 59 patients with MDD. Node-based FC analysis was employed to compare differences in FC patterns between melancholic and non-melancholic MDD patients. The support vector machines (SVM) method was then applied for classifying these two subtypes of MDD patients. RESULTS: CPM could successfully predict anhedonia symptoms in MDD patients (positive network: r = 0.4719, p < 0.0020, mean squared error = 23.5125, 5000 iterations). Compared to non-melancholic MDD patients, melancholic MDD patients showed decreased FC between the left cingulate gyrus and the right parahippocampus gyrus (p_bonferroni = 0.0303). This distinct FC pattern effectively discriminated between melancholic and non-melancholic MDD patients, achieving a sensitivity of 93.54%, specificity of 67.86%, and an overall accuracy of 81.36% using the SVM method. CONCLUSIONS: This study successfully established a network model for predicting anhedonia symptoms in MDD based on FC, as well as a classification model to differentiate between melancholic and non-melancholic MDD patients. These findings provide guidance for clinical treatment.


Assuntos
Anedonia , Encéfalo , Conectoma , Transtorno Depressivo Maior , Imageamento por Ressonância Magnética , Máquina de Vetores de Suporte , Humanos , Anedonia/fisiologia , Feminino , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Masculino , Adulto , Conectoma/métodos , Imageamento por Ressonância Magnética/métodos , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Adulto Jovem , Pessoa de Meia-Idade
11.
Soc Cogn Affect Neurosci ; 19(1)2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38874968

RESUMO

Peer victimization contributes to the development of major depressive disorders (MDDs). While previous studies reported differentiated peripheral physiological responses in peer-victimized individuals with depression, little is known about potential alterations of cortical event-related potentials (ERPs) in response to social stimuli in depressive patients with a history of peer victimization. Using a social condition paradigm, the present study examined whether peer victimization alters conditioned cortical responses to potentially threatening social stimuli in MDD patients and healthy controls. In the task, we studied ERPs to conditioned stimuli (CSs), i.e. still images of faces, that were coupled to unconditioned socially negative and neutral evaluative video statements. Peer victimization was related to more pronounced P100 amplitudes in reaction to negative and neutral CSs. Attenuated P200 amplitudes in peer-victimized individuals were found in response to negative CSs. Cortical responses to CSs were not influenced by a diagnosis of MDD. The results suggest altered responsiveness to interpersonal information in peer-victimized individuals. Facilitated early processing of social threat indicators may prevent peer-victimized individuals from adaptive responses to social cues, increasing their vulnerability for depression.


Assuntos
Vítimas de Crime , Transtorno Depressivo Maior , Eletroencefalografia , Potenciais Evocados , Grupo Associado , Humanos , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Feminino , Masculino , Adulto , Eletroencefalografia/métodos , Potenciais Evocados/fisiologia , Vítimas de Crime/psicologia , Estresse Psicológico/fisiopatologia , Estresse Psicológico/psicologia , Adulto Jovem , Córtex Cerebral/fisiopatologia , Córtex Cerebral/fisiologia , Pessoa de Meia-Idade , Percepção Social , Estimulação Luminosa/métodos , Bullying/psicologia
12.
BMC Womens Health ; 24(1): 350, 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38886733

RESUMO

BACKGROUND: Major depressive disorder (MDD) is a highly prevalent mental health disorder with females experiencing higher rates of depression (11.6%), anxiety (15.7%) and physiological distress (14.5%) than males. Recently, the Endocannabinoid system (ECS) has been proposed to be a key contributing factor in the pathogenesis and symptom severity of MDD due to its role in neurotransmitter production, inflammatory response and even regulation of the female reproductive cycle. This review critically evaluates evidence regarding ECS levels in female-sexed individuals with depressive disorders to further understand ECS role. MATERIALS AND METHODS: A systematic literature review of available research published prior to April 2022 was identified using PubMed (U.S. National Library of Medicine), CINAHL (EBSCO), Web of Science, AMED and Scopus (Elsevier). Studies were included if they reported ECS analysis of female-sexed individuals with depression and were excluded if they did not differentiate results between sexes, assessed mental health conditions other than depression, tested efficacy of endocannabinoid/n-acylethanolamine/cannabis or marijuana administration and that were unable to be translated. Critical appraisal of each included study was undertaken using the Joanna Briggs Institute Critical Appraisal Tool for Systematic Reviews. RESULTS: The 894 located citations were screened for duplicates (n = 357) and eligibility by title and abstract (n = 501). The full text of 33 studies were reviewed, and 7 studies were determined eligible for inclusion. These studies indicated that depressed female-sexed individuals have altered levels of ECS however no significant pattern was identified due to variability of study outcomes and measures, limiting overall interpretation. DISCUSSION: This review suggests potential involvement of ECS in underlying mechanisms of MDD in female sexed-individuals, however no pattern was able to be determined. A major contributor to the inability to attain reliable and valid understanding of the ECS levels in female-sexed individuals with depression was the inconsistency of depression screening tools, inclusion criteria's and analysis methods used to measure eCBs. Future studies need to implement more standardised methodology to gain a deeper understanding of ECS in female-sexed individuals with depressive disorders. TRIAL REGISTRATION : This review was submitted to PROSPERO for approval in April 2022 (Registration #CRD42022324212).


Assuntos
Transtorno Depressivo Maior , Endocanabinoides , Humanos , Endocanabinoides/metabolismo , Feminino , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Fatores Sexuais , Masculino
13.
Psychogeriatrics ; 24(4): 909-914, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38837519

RESUMO

BACKGROUND: Older adults with major depression are at risk of frailty and long-term care needs. Consequently, screening for major depression is imperative to prevent such risks. In Japan, the Late-Stage Elderly Questionnaire was developed to evaluate older adults' holistic health, including mental well-being. It comprises one specific question to gauge life satisfaction, but the effectiveness of this question to screen for major depression remains unclear. Therefore, we aimed to assess the usability of this question to screen for major depression. METHODS: This retrospective cohort study used a large, commercially available claims database in Japan. Participants were older adults aged ≥75 years who completed the Late-Stage Elderly Questionnaire and were classified with and without new major depression within 1 year. We evaluated the questionnaire's ability to screen for major depression using C-statistics, developing three models to assess the cut-off value based on responses to the life satisfaction question ('Satisfied', 'Somewhat satisfied', 'Somewhat unsatisfied', or 'Unsatisfied'), estimating the sensitivity and specificity of each model. RESULTS: Among 11 117 older adults, 77 newly experienced major depression within 1 year. The C-statistic for screening major depression was 0.587. The model setting the cut-off between 'Somewhat unsatisfied' and 'Unsatisfied' the demonstrated lowest sensitivity and highest specificity, while the model setting the cut-off between 'Satisfied' and 'Somewhat satisfied' demonstrated highest sensitivity and lowest specificity. CONCLUSIONS: Our results suggest that due to its poor screening ability and high rate of false negatives, the question assessing life satisfaction in the Late-Stage Elderly Questionnaire may not be useful for screening major depression in older adults and may require modification.


Assuntos
Transtorno Depressivo Maior , Programas de Rastreamento , Humanos , Idoso , Japão , Masculino , Feminino , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Inquéritos e Questionários , Estudos Retrospectivos , Idoso de 80 Anos ou mais , Programas de Rastreamento/métodos , Satisfação Pessoal , Avaliação Geriátrica/métodos , Sensibilidade e Especificidade , População do Leste Asiático
14.
Riv Psichiatr ; 59(3): 127-137, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38912760

RESUMO

INTRODUCTION: Mental health disorders and chronic health diseases are highly prevalent and impactful consequences of distressful experiences among refugees, yet a comprehensive conceptual model encompassing biopsychosocial factors is lacking. This study aims to assess the relevance of widowhood to PTSD and major depression maintenance as well as to adverse health outcomes in a cohort of Bosnian refugees. METHODS: This longitudinal study included 526 subjects followed up for 3 years. The interviews were conducted in refugee camps in Varazdin, Croatia, in the Bosnian language. Data were collected using the Harvard Trauma Questionnaire and Hopkins Checklist-25, respectively. Physical health disorders were self-reported. RESULTS: Both at baseline and endpoint female gender and marital loss are associated with a statistically significant higher burden of psychological and physical health outcomes. This group showed higher rates of PTSD and major depression disorders, as high comorbidity with hypertension, cardiovascular diseases, asthma and arthritis. DISCUSSION: The results of the present study align with a wealth of literature studies linking marital loss to shifts in mental health and impaired physical health. A conceptual framework is provided for understanding how both mental health and physical health outcomes are highly dependent on social phenomena. CONCLUSIONS: This investigation reinforces the hypothesis of the role of social bonds and marital support in recovery from trauma experiences. Further studies are, however, needed for a better understanding of the consequences of adverse events on trauma-exposed subjects from a holistic bio-psycho-social point of view.


Assuntos
Transtorno Depressivo Maior , Saúde Mental , Refugiados , Transtornos de Estresse Pós-Traumáticos , Humanos , Feminino , Refugiados/psicologia , Masculino , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estudos Longitudinais , Adulto , Pessoa de Meia-Idade , Bósnia e Herzegóvina , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Nível de Saúde , Croácia , Fatores Sexuais , Viuvez/psicologia
15.
BMJ Open ; 14(6): e077528, 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38904137

RESUMO

OBJECTIVES: Workplace stigmatisation and discrimination are significant barriers to accessing employment opportunities, reintegration and promotion in the workforce for people with mental illnesses in comparison to other disabilities. This paper presents qualitative evidence of anticipated and experienced workplace stigma and discrimination among individuals with major depressive disorder (MDD) in 35 countries, and how these experiences differ across countries based on their Human Development Index (HDI) level. DESIGN: Mixed-method cross-sectional survey. PARTICIPANTS, SETTING AND MEASURES: The qualitative data were gathered as part of the combined European Union Anti-Stigma Programme European Network and global International Study of Discrimination and Stigma Outcomes for Depression studies examining stigma and discrimination among individuals with MDD across 35 countries. Anticipated and experienced stigma and discrimination were assessed using the Discrimination and Stigma Scale version 12 (DISC-12). This study used responses to the open-ended DISC-12 questions related to employment. Data were analysed using the framework analysis method. RESULTS: The framework analysis of qualitative data of 141 participants identified 6 key 'frames' exploring (1) participants reported experiences of workplace stigma and discrimination; (2) impact of experienced workplace stigma and discrimination; (3) anticipated workplace stigma and discrimination; (4) ways of coping; (5) positive work experiences and (6) contextualisation of workplace stigma and discrimination. In general, participants from very high HDI countries reported higher levels of anticipated and experienced discrimination than other HDI groups (eg, less understanding and support, being more avoided/shunned, stopping themselves from looking for work because of expectation and fear of discrimination). Furthermore, participants from medium/low HDI countries were more likely to report positive workplace experiences. CONCLUSIONS: This study makes a significant contribution towards workplace stigma and discrimination among individuals with MDD, still an under-researched mental health diagnosis. These findings illuminate important relationships that may exist between countries/contexts and stigma and discrimination, identifying that individuals from very high HDI countries were more likely to report anticipated and experienced workplace discrimination.


Assuntos
Transtorno Depressivo Maior , Estigma Social , Local de Trabalho , Humanos , Estudos Transversais , Transtorno Depressivo Maior/psicologia , Masculino , Feminino , Adulto , Local de Trabalho/psicologia , Pessoa de Meia-Idade , Emprego/psicologia , Pesquisa Qualitativa , Discriminação Social/psicologia , Adulto Jovem , Inquéritos e Questionários
16.
Medicine (Baltimore) ; 103(25): e38588, 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38905381

RESUMO

Breast cancer is a global health concern that significantly impacts the quality of life (QOL) of individuals. This study aims to comprehensively examine the interplay between QOL and depression among nonmetastatic breast cancer patients in Lebanon, a region with limited research in this context. A cross-sectional study was conducted at Hammoud Hospital-University Medical Center from January 2018 to January 2023. Data was collected through a self-administered questionnaire distributed as Google Forms via WhatsApp. A total of 193 patients had non-metastatic breast cancer. Out of these, 81 valid responses were obtained. The Patient Health Questionnaire and Quality of Life Scale were used to assess depression and QOL, respectively. A total of 81 patients were included with mean age 54.4 years. Results revealed that 77.8% of patients experienced provisional depression, with 35.8% meeting criteria for major depressive disorder. Financial status and chronic diseases were associated with the likelihood of developing major depressive disorder. The mean QOL score was 81.14, lower than the average for healthy individuals. Educational level and presence of chronic diseases were significant factors influencing QOL. Postsurgical depression prevalence is substantial, underscoring the importance of integrating mental health care. Economic status and comorbidities are influential factors, necessitating targeted interventions. Breast cancer's impact on QOL is profound, falling below that of other chronic conditions. Education empowers coping, while comorbidities impact QOL. Our findings emphasize the multidimensional nature of breast cancer care, advocating for holistic support and addressing emotional well-being.


Assuntos
Neoplasias da Mama , Depressão , Qualidade de Vida , Humanos , Qualidade de Vida/psicologia , Feminino , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , Estudos Transversais , Líbano/epidemiologia , Pessoa de Meia-Idade , Adulto , Depressão/epidemiologia , Depressão/psicologia , Idoso , Inquéritos e Questionários , Prevalência , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia
17.
Int J Clin Exp Hypn ; 72(3): 229-253, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38861252

RESUMO

We investigated whether adding hypnosis to CBT (CBTH) improved treatment outcomes for MDD with a two-armed, parallel-treated, randomized-controlled trial using anonymous self-report and clinician-blinded assessments. Expectancy, credibility, and attitude to hypnosis were also examined. Participants (n = 66) were randomly allocated to 10-weekly sessions of group-based CBT or CBTH. LMM analyses of ITT and Completer data at post-treatment, six-month and 12-month follow-up showed that both treatments were probably efficacious but we did not find significant differences between them. Analyses of remission and response to treatment data revealed that the CBTH Completer group significantly outperformed CBT at 12-month follow-up (p = .011). CBTH also displayed significantly higher associations between credibility, expectancy and mood outcomes up to 12-month follow-up (all p < .05 or better), while attitude to hypnosis showed one significant association (r = -0.57, p < .05). These results suggest that hypnosis shows promise as an adjunct in the treatment of MDD but a larger sample size is required to fully test its merits.


Assuntos
Terapia Cognitivo-Comportamental , Transtorno Depressivo Maior , Hipnose , Humanos , Hipnose/métodos , Feminino , Masculino , Transtorno Depressivo Maior/terapia , Transtorno Depressivo Maior/psicologia , Terapia Cognitivo-Comportamental/métodos , Adulto , Pessoa de Meia-Idade , Resultado do Tratamento
18.
BMC Psychiatry ; 24(1): 434, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862969

RESUMO

BACKGROUND: Cognitive impairment is a recognized fundamental deficit in individuals diagnosed with schizophrenia (SZ), bipolar II disorder (BD II), and major depressive disorder (MDD), among other psychiatric disorders. However, limited research has compared cognitive function among first-episode drug-naïve individuals with SZ, BD II, or MDD. METHODS: This study aimed to address this gap by assessing the cognitive performance of 235 participants (40 healthy controls, 58 SZ patients, 72 BD II patients, and 65 MDD patients) using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) before and after 12 weeks of treatment in SZ, BD II, and MDD patients. To clarify, the healthy controls only underwent RBANS testing at baseline, whereas the patient groups were assessed before and after treatment. The severity of symptoms in SZ patients was measured using the Positive and Negative Syndrome Scale (PANSS), and depression in BD II and MDD patients was assessed using the Hamilton Depression Scale-24 items (HAMD-24 items). RESULTS: Two hundred participants completed the 12-week treatment period, with 35 participants dropping out due to various reasons. This group included 49 SZ patients, 58 BD II patients, and 53 MDD patients. Among SZ patients, significant improvements in immediate and delayed memory were observed after 12 weeks of treatment compared to their initial scores. Similarly, BD II patients showed significant improvement in immediate and delayed memory following treatment. However, there were no significant differences in RBANS scores for MDD patients after 12 weeks of treatment. CONCLUSIONS: In conclusion, the findings of this study suggest that individuals with BD II and SZ may share similar deficits in cognitive domains. It is important to note that standardized clinical treatment may have varying degrees of effectiveness in improving cognitive function in patients with BD II and SZ, which could potentially alleviate cognitive dysfunction.


Assuntos
Transtorno Bipolar , Transtorno Depressivo Maior , Esquizofrenia , Humanos , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/psicologia , Masculino , Feminino , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/psicologia , Adulto , Esquizofrenia/tratamento farmacológico , Esquizofrenia/fisiopatologia , Esquizofrenia/complicações , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/psicologia , Adulto Jovem , Testes Neuropsicológicos , Antipsicóticos/uso terapêutico , Escalas de Graduação Psiquiátrica , Pessoa de Meia-Idade
19.
J Affect Disord ; 361: 120-127, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-38851432

RESUMO

BACKGROUND: Childhood maltreatment (CM) is prevalent among patients with mood disorders and considered an important risk factor for suicide in the general population. Despite mood disorders being implicated in up to 60 % of completed suicides, the predictive role of CM on suicide attempt (SA) among early mood disorder patients remains poorly understood. METHODS: We enrolled 480 participants diagnosed with early-onset major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II). Over an average of 60 weeks, participants underwent follow-up assessments at 12-week intervals. Using multivariate logistic regression, we examined the association between CM and SA history at baseline. Further, the Cox proportional hazard model assessed the predictive role of childhood maltreatment in SA during follow-up. RESULTS: At baseline, 38 % of the total participants reported SA history, with a follow-up prevalence of 10 %. Childhood maltreatment was significantly associated with past SAs and was a robust predictor of future SA, adjusting for relevant clinical risk factors. Emotional abuse and sexual abuse related to SA history, and physical abuse increased future SA risk. LIMITATIONS: Potential biases in reporting SA and childhood maltreatment, along with unexplored factors such as additional environmental and familial risks, may affect the study's findings. CONCLUSIONS: Childhood maltreatment emerged as a robust predictor of SA among early-onset mood disorder patients. Systematic evaluation of CM early in the clinical process may be crucial for effective risk management. Additionally, our findings highlight the importance of implementing proactive interventions for CM to prevent the onset of adverse psychological trajectories.


Assuntos
Transtorno Bipolar , Transtorno Depressivo Maior , Tentativa de Suicídio , Humanos , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Feminino , Masculino , República da Coreia/epidemiologia , Tentativa de Suicídio/estatística & dados numéricos , Adulto , Estudos Prospectivos , Fatores de Risco , Adulto Jovem , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Prevalência , Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/psicologia , Adolescente , Modelos de Riscos Proporcionais
20.
J Affect Disord ; 361: 189-197, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-38866253

RESUMO

BACKGROUND: A critical challenge in the study and management of major depressive disorder (MDD) is predicting relapse. We examined the temporal correlation/coupling between depression and anxiety (called Depression-Anxiety Coupling Strength, DACS) as a predictor of relapse in patients with MDD. METHODS: We followed 97 patients with remitted MDD for an average of 394 days. Patients completed weekly self-ratings of depression and anxiety symptoms using the Quick Inventory of Depressive Symptoms (QIDS-SR) and the Generalized Anxiety Disorder 7-item scale (GAD-7). Using these longitudinal ratings we computed DACS as random slopes in a linear mixed effects model reflecting individual-specific degree of correlation between depression and anxiety across time points. We then tested DACS as an independent variable in a Cox proportional hazards model to predict relapse. RESULTS: A total of 28 patients (29 %) relapsed during the follow-up period. DACS significantly predicted confirmed relapse (hazard ratio [HR] 1.5, 95 % CI [1.01, 2.22], p = 0.043; Concordance 0.79 [SE 0.04]). This effect was independent of baseline depressive or anxiety symptoms or their average levels over the follow-up period, and was identifiable more than one month before relapse onset. LIMITATIONS: Small sample size, in a single study. Narrow phenotype and comorbidity profiles. CONCLUSIONS: DACS may offer opportunities for developing novel strategies for personalized monitoring, early detection, and intervention. Future studies should replicate our findings in larger, diverse patient populations, develop individual patient prediction models, and explore the underlying mechanisms that govern the relationship of DACS and relapse.


Assuntos
Ansiedade , Transtorno Depressivo Maior , Recidiva , Humanos , Transtorno Depressivo Maior/psicologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Ansiedade/psicologia , Modelos de Riscos Proporcionais , Depressão/psicologia , Transtornos de Ansiedade/psicologia , Escalas de Graduação Psiquiátrica
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