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1.
JAMA Netw Open ; 7(6): e2415325, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38842805

RESUMO

Importance: Rates of grief-related psychiatric conditions, such as prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD), among bereaved adults in the US are largely unknown due to limited studies that leverage national samples. Objective: To assess risk factors for and prevalence rates and co-occurrence of PGD, PTSD, and MDD among bereaved adults in the US. Design, Setting, and Participants: Data for this survey study were collected from a large US panel sample between October 10 and 28, 2022, using a web-based survey. Participants were aged 18 years or older and were proficient in English. Data analysis was conducted between March and June 2023. Main Outcomes and Measures: Probable psychiatric conditions were assessed with validated measures that used conservative cutoff scores, duration, and impairment criteria. These measures included the revised Prolonged Grief Disorder scale for PGD, the PTSD Checklist for DSM-5 for PTSD, and the Patient Health Questionnaire-9 for MDD. Data were analyzed using basic descriptives and logistic regression. Results: A total of 2034 adults (n = 1529 and 505 in the bereaved and comparison groups, respectively) completed the study. Respondents had a mean (SD) age of 40.7 (15.9) years; the majority were women (1314 [64.6%]) and had at least some college experience (1394 [68.5%]). With regard to race and ethnicity, 392 respondents (19.3%) were Black, 138 (6.8%) were Hispanic, and 1357 (66.7%) were White. Among bereaved adults, 312 (20.4%), 518 (33.9%), and 461 (30.2%) met criteria for a presumptive diagnosis of PGD, PTSD, and MDD, respectively. Comorbidities were common, with 441 participants (28.8%) meeting criteria for at least 2 co-occurring disorders. Comorbid PGD, PTSD, and MDD were more common than any 2 co-occurring or isolated disorders; the presence of co-occurring conditions was more likely among respondents who reported a traumatic loss. Age and educational attainment were associated with the risk of psychiatric conditions; less time since the index death, loss of a psychologically close other, and a traumatic loss experience were associated with increased risk of PGD, PTSD, and MDD or their co-occurrence. Conclusions and Relevance: In this study, the majority of bereaved adults did not meet presumptive criteria for PGD, PTSD, or MDD. Nevertheless, PGD, PTSD, and MDD were highly prevalent and comorbid, particularly among those who experienced traumatic loss. These findings underscore the need for integrated psychological care that leverages transdiagnostic mechanisms of evidence-based practice.


Assuntos
Luto , Transtorno Depressivo Maior , Transtornos de Estresse Pós-Traumáticos , Humanos , Feminino , Masculino , Adulto , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Pessoa de Meia-Idade , Prevalência , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Estados Unidos/epidemiologia , Pesar , Comorbidade , Idoso , Fatores de Risco , Adulto Jovem , Adolescente , Inquéritos e Questionários
2.
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
3.
PLoS One ; 19(5): e0302229, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38709769

RESUMO

INTRODUCTION: Major Depressive Disorder (MDD) is one of the most prevalent mental disorders worldwide with significant personal and public health consequences. After an episode of MDD, the likelihood of relapse is high. Therefore, there is a need for interventions that prevent relapse of depression when outpatient mental health care treatment has ended. This scoping review aimed to systematically map the evidence and identify knowledge gaps in interventions that aimed to promote recovery from MDD for patients transitioning from outpatient mental health services to primary care. MATERIALS AND METHODS: We followed the guidance by Joanna Briggs Institute in tandem with the PRISMA extension for Scoping Reviews checklist. Four electronic databases were systematically searched using controlled index-or thesaurus terms and free text terms, as well as backward and forward citation tracking of included studies. The search strategy was based on the identification of any type of intervention, whether simple, multicomponent, or complex. Three authors independently screened for eligibility and extracted data. RESULTS: 18 studies were included for review. The studies had high heterogeneity in design, methods, sample size, recovery rating scales, and type of interventions. All studies used several elements in their interventions; however, the majority used cognitive behavioural therapy conducted in outpatient mental health services. No studies addressed the transitioning phase from outpatient mental health services to primary care. Most studies included patients during their outpatient mental health care treatment of MDD. CONCLUSIONS: We identified several knowledge gaps. Recovery interventions for patients with MDD transitioning from outpatient mental health services to primary care are understudied. No studies addressed interventions in this transitioning phase or the patient's experience of the transitioning process. Research is needed to bridge this gap, both regarding interventions for patients transitioning from secondary to primary care, and patients' and health care professionals' experiences of the interventions and of what promotes recovery. REGISTRATION: A protocol was prepared in advance and registered in Open Science Framework (https://osf.io/ah3sv), published in the medRxiv server (https://doi.org/10.1101/2022.10.06.22280499) and in PLOS ONE (https://doi.org/10.1371/journal.pone.0291559).


Assuntos
Transtorno Depressivo Maior , Serviços de Saúde Mental , Atenção Primária à Saúde , Humanos , Transtorno Depressivo Maior/terapia , Transtorno Depressivo Maior/psicologia , Pacientes Ambulatoriais/psicologia , Assistência Ambulatorial , Terapia Cognitivo-Comportamental/métodos
4.
Sci Rep ; 14(1): 10754, 2024 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-38730229

RESUMO

Despite the critical role of self-disturbance in psychiatric diagnosis and treatment, its diverse behavioral manifestations remain poorly understood. This investigation aimed to elucidate unique patterns of self-referential processing in affective disorders and first-episode schizophrenia. A total of 156 participants (41 first-episode schizophrenia [SZ], 33 bipolar disorder [BD], 44 major depressive disorder [MDD], and 38 healthy controls [HC]) engaged in a self-referential effect (SRE) task, assessing trait adjectives for self-descriptiveness, applicability to mother, or others, followed by an unexpected recognition test. All groups displayed preferential self- and mother-referential processing with no significant differences in recognition scores. However, MDD patients showed significantly enhanced self-referential recognition scores and increased bias compared to HC, first-episode SZ, and BD. The present study provides empirical evidence for increased self-focus in MDD and demonstrates that first-episode SZ and BD patients maintain intact self-referential processing abilities. These findings refine our understanding of self-referential processing impairments across psychiatric conditions, suggesting that it could serve as a supplementary measure for assessing treatment response in first-episode SZ and potentially function as a discriminative diagnostic criterion between MDD and BD.


Assuntos
Transtorno Bipolar , Transtorno Depressivo Maior , Esquizofrenia , Psicologia do Esquizofrênico , Autoimagem , Humanos , Feminino , Masculino , Adulto , Esquizofrenia/fisiopatologia , Transtorno Bipolar/psicologia , Transtorno Bipolar/fisiopatologia , Transtorno Depressivo Maior/psicologia , Adulto Jovem , Estudos de Casos e Controles , Pessoa de Meia-Idade
5.
Trials ; 25(1): 320, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38750599

RESUMO

BACKGROUND: Comorbid anxiety disorders and anxious distress are highly prevalent among individuals with major depressive disorder (MDD). The presence of the DSM-5 anxious distress specifier (ADS) has been associated with worse treatment outcomes and chronic disease course. Few studies have evaluated the therapeutic effects of High-definition transcranial direct current stimulation (HD-tDCS) on depressive and anxiety symptoms among MDD patients with ADS. The current randomized controlled trial aims to assess the efficacy of HD-tDCS as an augmentation therapy with antidepressants compared to sham-control in subjects of MDD with ADS. METHODS: MDD patients with ADS will be recruited and randomly assigned to the active HD-tDCS or sham HD-tDCS group. In both groups, patients will receive the active or sham intervention in addition to their pre-existing antidepressant therapy, for 2 weeks with 5 sessions per week, each lasting 30 min. The primary outcome measures will be the change of depressive symptoms, clinical response, and the remission rate as measured with the 17-item Hamilton Depression Rating Scale (HDRS-17) before and after the intervention and at the 2nd and 6th week after the completed intervention. Secondary outcome measures include anxiety symptoms, cognitive symptoms, disability assessment, and adverse effects. DISCUSSION: The HD-tDCS applied in this trial may have treatment effects on MDD with ADS and have minimal side effects. TRIAL REGISTRATION: The trial protocol is registered with www.chictr.org.cn under protocol registration number ChiCTR2300071726. Registered 23 May 2023.


Assuntos
Transtorno Depressivo Maior , Ensaios Clínicos Controlados Aleatórios como Assunto , Estimulação Transcraniana por Corrente Contínua , Humanos , Transtorno Depressivo Maior/terapia , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/diagnóstico , Estimulação Transcraniana por Corrente Contínua/métodos , Método Duplo-Cego , Resultado do Tratamento , Adulto , Antidepressivos/uso terapêutico , Pessoa de Meia-Idade , Masculino , Feminino , Ansiedade/terapia , Ansiedade/psicologia , Ansiedade/diagnóstico , Transtornos de Ansiedade/terapia , Transtornos de Ansiedade/psicologia , Adulto Jovem , Terapia Combinada , Adolescente
6.
BMC Public Health ; 24(1): 1447, 2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38816820

RESUMO

BACKGROUND: The effort-reward imbalance (ERI) model is a widely used theoretical model to measure stress in the workplace. The objective of this study was to investigate the relationship between ERI and three common mental disorders: major depressive disorder (MDD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD). METHODS: In this cross-sectional analysis, the study sample consisted of 4453 baseline participants of the Employees' Health Cohort Study of Iran (EHCSIR). Trained psychologists utilized the Persian version of the Composite International Diagnostic Interview (CIDI-2.1) during the baseline assessment to identify common mental disorders. Additionally, the validated Persian version of the 23-item ERI questionnaire was employed to assess effort, reward, overcommitment, and effort-reward ratio. To examine the association of ERI components with three common mental disorders (MDD, GAD, and OCD) over the past twelve months, multiple logistic regression analyses were conducted. RESULTS: The prevalence of effort-reward imbalance in the study sample was 47.1%. Higher ERI score was significantly associated with MDD (OR: 3.43, 95% CI: 2.30-5.13), GAD (OR: 2.42, 95% CI: 1.27-4.63), and OCD (OR: 2.23, 95% CI:1.19-4.19). The study participants who reported higher scores on work overcommitment had a higher likelihood of having MDD (OR: 1.16, 95% CI:1.10-1.23), GAD (OR: 1.07, 95% CI: 1.01-1.14), and OCD (OR: 1.19, 95% CI: 1.09-1.29). CONCLUSIONS: According to the study's findings, work-related stress, as determined by the ERI model, is a significant factor in the development of common mental disorders among employees in the public sector.


Assuntos
Transtornos de Ansiedade , Transtorno Depressivo Maior , Recompensa , Humanos , Irã (Geográfico)/epidemiologia , Estudos Transversais , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/psicologia , Setor Público , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Inquéritos e Questionários
7.
Sci Rep ; 14(1): 12000, 2024 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-38796509

RESUMO

In a retrospective study, 54 patients with treatment-resistant major depressive disorder (TRD) completed a free-viewing task in which they had to freely explore pairs of faces (an emotional face (happy or sad) opposite to a neutral face). Attentional bias to emotional faces was calculated for early and sustained attention. We observed a significant negative correlation between depression severity as measured by the 10-item Montgomery-Åsberg Depression Rating Scale (MADRS) and sustained attention to happy faces. In addition, we observed a positive correlation between depression severity and sustained attention to sad faces. No significant correlation between depression severity and early attention was found for either happy or sad faces. Although conclusions from the current study are limited by the lack of comparison with a control group, the eye-tracking free-viewing task appears to be a relevant, accessible and easy-to-use tool for measuring depression severity through emotional attentional biases in TRD.


Assuntos
Viés de Atenção , Transtorno Depressivo Maior , Emoções , Expressão Facial , Humanos , Masculino , Feminino , Adulto , Viés de Atenção/fisiologia , Pessoa de Meia-Idade , Emoções/fisiologia , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/fisiopatologia , Estudos Retrospectivos , Tecnologia de Rastreamento Ocular , Transtorno Depressivo Resistente a Tratamento/psicologia , Índice de Gravidade de Doença , Atenção/fisiologia
8.
J Med Internet Res ; 26: e53968, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38767953

RESUMO

BACKGROUND: In 2023, the United States experienced its highest- recorded number of suicides, exceeding 50,000 deaths. In the realm of psychiatric disorders, major depressive disorder stands out as the most common issue, affecting 15% to 17% of the population and carrying a notable suicide risk of approximately 15%. However, not everyone with depression has suicidal thoughts. While "suicidal depression" is not a clinical diagnosis, it may be observed in daily life, emphasizing the need for awareness. OBJECTIVE: This study aims to examine the dynamics, emotional tones, and topics discussed in posts within the r/Depression subreddit, with a specific focus on users who had also engaged in the r/SuicideWatch community. The objective was to use natural language processing techniques and models to better understand the complexities of depression among users with potential suicide ideation, with the goal of improving intervention and prevention strategies for suicide. METHODS: Archived posts were extracted from the r/Depression and r/SuicideWatch Reddit communities in English spanning from 2019 to 2022, resulting in a final data set of over 150,000 posts contributed by approximately 25,000 unique overlapping users. A broad and comprehensive mix of methods was conducted on these posts, including trend and survival analysis, to explore the dynamic of users in the 2 subreddits. The BERT family of models extracted features from data for sentiment and thematic analysis. RESULTS: On August 16, 2020, the post count in r/SuicideWatch surpassed that of r/Depression. The transition from r/Depression to r/SuicideWatch in 2020 was the shortest, lasting only 26 days. Sadness emerged as the most prevalent emotion among overlapping users in the r/Depression community. In addition, physical activity changes, negative self-view, and suicidal thoughts were identified as the most common depression symptoms, all showing strong positive correlations with the emotion tone of disappointment. Furthermore, the topic "struggles with depression and motivation in school and work" (12%) emerged as the most discussed topic aside from suicidal thoughts, categorizing users based on their inclination toward suicide ideation. CONCLUSIONS: Our study underscores the effectiveness of using natural language processing techniques to explore language markers and patterns associated with mental health challenges in online communities like r/Depression and r/SuicideWatch. These insights offer novel perspectives distinct from previous research. In the future, there will be potential for further refinement and optimization of machine classifications using these techniques, which could lead to more effective intervention and prevention strategies.


Assuntos
COVID-19 , Ideação Suicida , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Processamento de Linguagem Natural , Depressão/psicologia , Pandemias , Estados Unidos , Mídias Sociais , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Transtorno Depressivo Maior/psicologia , SARS-CoV-2
9.
Artigo em Inglês | MEDLINE | ID: mdl-38701878

RESUMO

BACKGROUND: Anhedonia, a core symptom of major depressive disorder (MDD), manifests in two forms: anticipatory and consummatory, reflecting a diminished capacity to anticipate or enjoy pleasurable activities. Prior studies suggest that brain-derived neurotrophic factor (BDNF) and interleukin-10 (IL-10) may play key roles in the emergence of anhedonia in MDD. The specific relationships between these biomarkers and the two forms of anhedonia remain unclear. This study investigated the potential links between BDNF, IL-10, and both forms of anhedonia in MDD patients. METHODS: This study included 43 participants diagnosed with MDD and 58 healthy controls. It involved detailed assessments of depression and anxiety levels, anticipatory and consummatory pleasure, cognitive functions, and a broad spectrum of plasma biomarkers, such as C-reactive protein, various interleukins, and BDNF. Using partial correlation, variables related to pleasant experiences were identified. Stepwise multiple linear regression analysis was applied to pinpoint the independent predictors of anhedonia in the MDD group. RESULTS: Demographically, both groups were comparable in terms of age, sex, body mass index, educational year, and marital status. Individuals with MDD displayed markedly reduced levels of anticipatory and consummatory pleasure, higher anxiety, and depression scores compared to healthy controls. Additionally, cognitive performance was notably poorer in the MDD group. These patients also had lower plasma diamine oxidase levels. Analysis linked anhedonia to impaired delayed memory. Regression results identified IL-10 and BDNF as independent predictors of anticipatory and consummatory anhedonia, respectively. CONCLUSION: These findings demonstrate that anticipatory and consummatory anhedonia are influenced by independent factors, thereby providing critical insights into the distinct neuroimmunological mechanisms that underlie various forms of anhedonia. Clinicl Trial Registration Number: NCT03790085.


Assuntos
Anedonia , Fator Neurotrófico Derivado do Encéfalo , Transtorno Depressivo Maior , Interleucina-10 , Humanos , Transtorno Depressivo Maior/sangue , Transtorno Depressivo Maior/psicologia , Masculino , Anedonia/fisiologia , Fator Neurotrófico Derivado do Encéfalo/sangue , Feminino , Adulto , Interleucina-10/sangue , Pessoa de Meia-Idade , Biomarcadores/sangue , Adulto Jovem
10.
J Psychosom Res ; 182: 111691, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38718690

RESUMO

OBJECTIVE: Major depressive disorder (MDD), anxiety disorders, and somatic symptom disorder (SSD) are associated with quality of life (QoL) reduction. This cross-sectional study investigated the relationship between these conditions as categorical diagnoses and related psychopathologies with QoL, recognizing their frequent overlap. METHODS: We recruited a total of 403 clinical patients and healthy individuals, administering diagnostic interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. QoL and psychopathologies were assessed using the WHO Quality of Life-BREF (WHOQOL-BREF) and several self-administered questionnaires, respectively. Multiple linear regression analyses examined the associations between psychiatric diagnoses, psychopathologies, and QoL. RESULTS: SSD and MDD were independently associated with impaired global (ß = -0.318 and - 0.287) and all QoL domains (ß = -0.307, -0.150, -0.125, and - 0.133, in physical, psychological, social, and environmental domains respectively for SSD; ß = -0.278, -0.344, -0.275, and - 0.268 for MDD). The Beck Depression Inventory-II score showed pervasive associations with QoL (ß = -0.390, -0.408, -0.685, -0.463, and - 0.420, in global, physical, psychological, social, and environmental domains). The Patient Health Questionnaire-15 and Health Anxiety Questionnaire scores were associated with global (ß = -0.168 and - 0.181) and physical (ß = -0.293 and - 0.121) QoL domain, while the Cognitions About Body and Health Questionnaire score was only associated with environmental QoL domain (ß = -0.157). CONCLUSION: SSD and MDD were independently associated with QoL impairment. Depressive symptoms were associated with all QoL domains, whereas somatic symptom burden and health anxiety primarily affected the physical QoL domain. Clinicians should consider concomitant psychopathologies when managing patients with depression, anxiety, or somatic symptoms.


Assuntos
Transtornos de Ansiedade , Transtorno Depressivo Maior , Sintomas Inexplicáveis , Qualidade de Vida , Transtornos Somatoformes , Humanos , Qualidade de Vida/psicologia , Masculino , Feminino , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/diagnóstico , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/diagnóstico , Transtornos Somatoformes/psicologia , Transtornos Somatoformes/diagnóstico , Inquéritos e Questionários , Escalas de Graduação Psiquiátrica
11.
Psychiatry Res Neuroimaging ; 341: 111827, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38788296

RESUMO

Major Depressive Disorder (MDD) is a global problem. Currently, the most common diagnosis is based on criteria susceptible to the subjectivity of the patient and the clinician. A possible solution to this problem is to look for diagnostic biomarkers that can accurately and early detect this mental condition. Some researchers have focused on electroencephalogram (EEG) analysis to identify biomarkers. In this study we used a dataset composed of EEG recordings from 24 subjects with MDD and 29 healthy controls (HC), during the execution of affective priming tasks with three different emotional stimuli (images): fear, sadness, and happiness. We investigated abnormalities in depressed patients using a novel technique, by directly comparing Event-Related Potential (ERP) waveforms to find statistically significant differences between the MMD and HC groups. Compared to the control group (healthy subjects), we found out that for the emotions fear and happiness there is a decrease in cortical activity at temporal regions in MDD patients. Just the opposite, for the emotion sadness, an increase in MDD brain activity occurs in frontal and occipital regions. Our findings suggest that emotions regulate the attentional control of cognitive processing and are promising for clinical application in diagnosing patients with MDD more objectively.


Assuntos
Transtorno Depressivo Maior , Eletroencefalografia , Emoções , Potenciais Evocados , Humanos , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/diagnóstico , Masculino , Feminino , Potenciais Evocados/fisiologia , Adulto , Emoções/fisiologia , Adulto Jovem , Pessoa de Meia-Idade , Encéfalo/fisiopatologia , Encéfalo/diagnóstico por imagem
12.
J Vis Exp ; (206)2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38738908

RESUMO

Cognitive symptoms and sleep disturbance (SD) are common non-mood-related symptoms of major depressive disorder (MDD). In clinical practice, both cognitive symptoms and SD are related to MDD progression. However, there are only a few studies investigating the connection between cognitive symptoms and SD in patients with MDD, and only preliminary evidence suggests a significant association between cognitive symptoms and SD in patients with mood disorders. This study investigates the relationship between cognitive symptoms and sleep quality in patients with major depressive disorder. Patients (n = 20) with MDD were enrolled; their mean Hamilton Depression Scale-17 score was 21.95 (±2.76). Gold standard polysomnography (PSG) was used to assess sleep quality, and the validated THINC-integrated tool (the cognitive screening tool) was used to evaluate cognitive function in MDD patients. Overall, the results showed significant correlations between the cognitive screening tool's total score and sleep latency, wake-after-sleep onset, and sleep efficiency. These findings indicate that cognitive symptoms are associated with poor sleep quality among patients with MDD.


Assuntos
Cognição , Transtorno Depressivo Maior , Polissonografia , Qualidade do Sono , Humanos , Transtorno Depressivo Maior/psicologia , Adulto , Masculino , Feminino , Pessoa de Meia-Idade , Cognição/fisiologia , Polissonografia/métodos , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/psicologia
13.
J Affect Disord ; 355: 254-264, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38561155

RESUMO

BACKGROUND: The diagnosis of major depressive disorder (MDD) is commonly based on the subjective evaluation by experienced psychiatrists using clinical scales. Hence, it is particularly important to find more objective biomarkers to aid in diagnosis and further treatment. Alpha-band activity (7-13 Hz) is the most prominent component in resting electroencephalogram (EEG), which is also thought to be a potential biomarker. Recent studies have shown the existence of multiple sub-oscillations within the alpha band, with distinct neural underpinnings. However, the specific contribution of these alpha sub-oscillations to the diagnosis and treatment of MDD remains unclear. METHODS: In this study, we recorded the resting-state EEG from MDD and HC populations in both open and closed-eye state conditions. We also assessed cognitive processing using the MATRICS Consensus Cognitive Battery (MCCB). RESULTS: We found that the MDD group showed significantly higher power in the high alpha range (10.5-11.5 Hz) and lower power in the low alpha range (7-8.5 Hz) compared to the HC group. Notably, high alpha power in the MDD group is negatively correlated with working memory performance in MCCB, whereas no such correlation was found in the HC group. Furthermore, using five established classification algorithms, we discovered that combining alpha oscillations with MCCB scores as features yielded the highest classification accuracy compared to using EEG or MCCB scores alone. CONCLUSIONS: Our results demonstrate the potential of sub-oscillations within the alpha frequency band as a potential distinct biomarker. When combined with psychological scales, they may provide guidance relevant for the diagnosis and treatment of MDD.


Assuntos
Transtorno Depressivo Maior , Humanos , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Consenso , Eletroencefalografia , Cognição , Biomarcadores
14.
BMC Psychiatry ; 24(1): 302, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38654222

RESUMO

BACKGROUND: The devastating health, economic, and social consequences of COVID-19 may harm the already vulnerable groups, particularly people with severe psychiatric disorders (SPDs). The present study was conducted to investigate the anxiety response of patients with SPDs during the COVID-19 pandemic. METHODS: A total of 351 patients with SPDs [Schizophrenia Spectrum (SSD), Bipolar (BD), Major Depressive (MDD), and Obsessive-Compulsive (OCD) Disorders] and healthy controls in Guilan province, Iran, throughout 2021-2022 were included in this cross-sectional analytical study. The anxiety response consisted of four concepts: COVID-19-related anxiety, general health anxiety, anxiety sensitivity, and safety behaviors. We conducted an unstructured interview and provided sociodemographic and clinical information. Also, the participants were asked to complete four self-report measures of the Corona Disease Anxiety Scale, the Anxiety Sensitivity Index-Revised, the Short Health Anxiety Inventory, and the Checklist of Safety Behaviors. RESULTS: Analysis of variance showed a significant difference between the groups of patients with SPDs and the control group in COVID-19-related anxiety (F = 6.92, p = 0.0001), health anxiety (F = 6.21, p = 0.0001), and safety behaviors (F = 2.52, p = 0.41). No significant difference was observed between them in anxiety sensitivity (F = 1.77, p = 0.134). The Games-Howell test showed that the control group obtained a higher mean than the groups of people with BD (p < 0.0001), SSD (p = 0.033), and OCD (p = 0.003) disorders in COVID-19-related anxiety. The patients with MDD (p = 0.014) and OCD (p = 0.01) had a higher mean score than the control group in health anxiety. Tukey's test showed that the mean of safety behaviors of the control group was significantly higher than the OCD group (p = 0.21). No significant difference was found between the groups of patients with MDD, BD, SSD, and OCD in terms of COVID-19-related anxiety, health anxiety, and safety behaviors. CONCLUSION: Anxiety response to health crisis is different in groups with SPDs and control group. The findings of this study suggest that although health anxiety is present in many of these patients during the pandemic, their anxiety response to the health crisis may be less than expected. There can be various explanations, such as pre-existing symptoms, low health literacy, and possible co-occurring cognitive impairment. The results of this study have many practical and policy implications in meeting the treatment needs of this group of patients during public health crises and indicate that their needs may not be compatible with the expectations and estimates that health professionals and policymakers already have.


Assuntos
Ansiedade , COVID-19 , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Masculino , Feminino , Adulto , Estudos Transversais , Ansiedade/psicologia , Ansiedade/epidemiologia , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Saúde Pública , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Transtorno Bipolar/psicologia , Transtorno Bipolar/epidemiologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Esquizofrenia/epidemiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , SARS-CoV-2
15.
Clin Psychol Psychother ; 31(2): e2990, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38659274

RESUMO

BACKGROUND: The prevalence of suicide is high among major depressive adolescents. Poor sleep quality has been documented as a significant risk factor for suicide, influencing perceived social support. Enhanced social support acts as a buffer against suicidal ideation and positively impacts resilience, reducing the prevalence of suicidal ideation. This reciprocal relationship between sleep quality, social support and resilience forms the basis for understanding the mechanisms contributing to suicidal ideation in major depressive adolescents. METHODS: A total of 585 major depressive adolescents aged 11 to 24 years was conducted to explore these associations. Assessments included the Pittsburgh Sleep Quality Index, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and Beck Scale for Suicide Ideation. Pearson correlation and Model 6 in the SPSS program were employed for chain mediating tests. RESULTS: Better sleep quality positively predicted decreased suicide ideation (ß = 0.207, p < 0.01) and predicted lower perceived social support (ß = -0.226, p < 0.01) and resilience (ß = -0.355, p < 0.01). Perceived social support positively predicted increased resilience (ß = 0.422, p < 0.01) and negatively predicted suicide ideation (ß = -0.288, p < 0.01). Resilience negatively predicted suicide ideation (ß = -0.187, p < 0.01). Sleep quality indirectly predicted suicide ideation through perceived social support and resilience, with a mediation value of 0.0678 (95% CI [0.0359, 0.1060]), constituting 10.65% of the total effect. CONCLUSIONS: This study establishes that sleep quality indirectly predicts suicide ideation in major depressive adolescents, mediated independently by perceived social support and resilience.


Assuntos
Transtorno Depressivo Maior , Resiliência Psicológica , Qualidade do Sono , Apoio Social , Ideação Suicida , Humanos , Adolescente , Feminino , Masculino , Transtorno Depressivo Maior/psicologia , Criança , Adulto Jovem , Fatores de Risco
16.
BMC Psychiatry ; 24(1): 311, 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38658936

RESUMO

BACKGROUND: Few studies have focused on functional impairment in depressed patients during symptomatic remission. The exact relationship between cognitive performance and functional outcomes of patients with Major depressive disorder (MDD) remains unclear. METHODS: Participants diagnosed with MDD were included and interviewed at both baseline and follow-up. Cognitive function was assessed during acute episodes using the Cambridge Neuropsychological Test Automated Battery (CANTAB), which targeted attention (Rapid Visual Processing - RVP), visual memory (Pattern Recognition Memory - PRM), and executive function (Intra-Extra Dimensional Set Shift - IED). The 17-item Hamilton Depression Scale (HAMD) was used for symptom assessment. Participants were divided into two groups based on their SDSS (Social Disability Screening Schedule) scores, and the differences between their demographic information, HAMD scores, and baseline CANTAB test results were compared. Logistic regression analysis was used to identify cognitive predictors of social function during symptomatic remission. RESULTS: According to the SDSS score at follow-up, 103 patients were divided into the normal social function group (n = 81,78.6%) and the poor social function group (n = 22, 21.4%) during clinical remission. Participants with poorer social function performed worse in the visual memory (PRM) and executive function tests (IED) at the baseline. Logistic regression analysis suggested that performance on the PRM (95%CI = 0.31-0.93, p = 0.030) and IED (95%CI = 1.01-1.13, p = 0.014) tests, instead of less severe symptoms, significantly contributed to functional outcomes. CONCLUSION: Better performance in visual memory and executive function during acute episodes may predict better social functional outcomes in individuals with MDD. A potential early intervention to improve social function in individuals with MDD could include the treatments for executive function and visual memory.


Assuntos
Transtorno Depressivo Maior , Função Executiva , Testes Neuropsicológicos , Humanos , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Feminino , Masculino , Adulto , Função Executiva/fisiologia , Pessoa de Meia-Idade , Indução de Remissão , Cognição/fisiologia , Atenção/fisiologia , Escalas de Graduação Psiquiátrica , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/psicologia
17.
CNS Spectr ; 29(3): 197-205, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38685584

RESUMO

OBJECTIVE: To examine whether objective sleep parameters are associated with cognitive function (CF) in patients with major depressive disorder (MDD) with chronic insomnia (CI) and whether the severity of these disorders is related to CF. METHOD: Thirty patients with MDD with CI attending a tertiary care institution underwent two consecutive nights of polysomnographic (PSG) recording and a battery of neuropsychological tests, which included episodic memory, sustained attention, working memory, and executive function. The severity of MDD and CI was assessed by clinical scales. We examined the relationship between PSG parameters and CF, as well as whether the severity of the disorders is related to CF. RESULTS: Linear regression analysis revealed that total sleep time (TST) was positively associated with higher learning and recall of episodic memory, as well as better attention. Slow-wave sleep (SWS) showed a positive association with better working memory. Furthermore, wake after sleep onset (WASO) was negatively associated with episodic memory and lower attention. No significant relationships were found between the severity of MDD or CI with CF. CONCLUSION: Both sleep duration and depth are positively associated with several aspects of CF in patients with MDD with CI. Conversely, a lack of sleep maintenance is negatively related to CF in these patients. These findings could help identify modifiable therapeutic targets to reduce CF impairment.


Assuntos
Transtorno Depressivo Maior , Polissonografia , Distúrbios do Início e da Manutenção do Sono , Humanos , Distúrbios do Início e da Manutenção do Sono/psicologia , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Masculino , Feminino , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/fisiopatologia , Adulto , Pessoa de Meia-Idade , Cognição , Testes Neuropsicológicos , Atenção , Memória de Curto Prazo , Memória Episódica
18.
CNS Spectr ; 29(3): 206-214, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38685594

RESUMO

OBJECTIVE: Serotonin norepinephrine reuptake inhibitors (SNRIs) have been postulated to afford benefits in alleviating anhedonia and amotivation. This post hoc pooled analysis evaluated the effect of venlafaxine XR, an SNRI, on these symptoms in patients with major depressive disorder (MDD). METHODS: Data was pooled from five short-term randomized, placebo-controlled studies of venlafaxine XR for the treatment of MDD, comprising 1087 (venlafaxine XR, n = 585; placebo, n = 502) adult subjects. The change from baseline score in the MADRS anhedonia factor (based on items 1 [apparent sadness], 2 [reported sadness], 6 [concentration difficulties], 7 [lassitude], and 8 [inability to feel]) for anhedonia, and in motivational deficits (based on 3 items of HAM-D17: involvement in work and activities, psychomotor retardation, and energy level [ie, general somatic symptoms]) for amotivation, were measured through 8 weeks. Mixed model repeated measures (MMRMs) were used to analyze changes over time and ANCOVA to analyze the change from baseline at week 8 with LOCF employed to handle missing data. RESULTS: At the end of 8 weeks, the change from baseline was significantly greater in patients on venlafaxine XR in both anhedonia (mean, 95% CI: -2.73 [-3.63, -1.82], p < 0.0001) and amotivation scores (mean, 95% CI: -0.78 [-1.04, -0.52], p < 0.0001) than those on placebo. For both measures, the between-group separation from baseline was statistically significant starting from week 2 onwards, and it increased over time. CONCLUSION: This analysis demonstrates that venlafaxine XR is effective in improving symptoms of anhedonia and motivational deficits in patients with MDD.


Assuntos
Anedonia , Transtorno Depressivo Maior , Cloridrato de Venlafaxina , Humanos , Cloridrato de Venlafaxina/uso terapêutico , Cloridrato de Venlafaxina/administração & dosagem , Cloridrato de Venlafaxina/farmacologia , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/psicologia , Anedonia/efeitos dos fármacos , Adulto , Masculino , Feminino , Pessoa de Meia-Idade , Motivação , Antidepressivos de Segunda Geração/uso terapêutico , Antidepressivos de Segunda Geração/administração & dosagem , Cicloexanóis/uso terapêutico , Cicloexanóis/administração & dosagem , Resultado do Tratamento , Método Duplo-Cego
19.
BMC Psychiatry ; 24(1): 331, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38689265

RESUMO

BACKGROUND: To examine the factor structure and psychometric properties of the Patient Health Questionnaire for Adolescents (PHQ-A) in Chinese children and adolescents with major depressive disorder (MDD). METHODS: A total of 248 MDD patients aged between 12 and 18 years were recruited and evaluated by the Patient Health Questionnaire for Adolescents (PHQ-A), the Center for Epidemiological Survey Depression Scale (CES-D), the Mood and Feelings Questionnaire (MFQ), and the improved Clinical Global Impression Scale, Severity item (iCGI-S). Thirty-one patients were selected randomly to complete the PHQ-A again one week later. Confirmatory factor analysis (CFA) was used to test the construct validity of the scale. Reliability was evaluated by Macdonald Omega coefficient. Pearson correlation coefficient was used to assess the item-total correlation and the correlation of PHQ-A with CES-D and MFQ respectively. Spearman correlation coefficient was used to assess test-retest reliability. The optimal cut-off value, sensitivity, and specificity of the PHQ-A were achieved by estimating the Receiver Operating Characteristics (ROC) curve. RESULTS: CFA reported adequate loadings for all items, except for item 3. Macdonald Omega coefficient of the PHQ-A was 0.87. The Spearman correlation coefficient of the test-retest reliability was 0.70. The Pearson correlation coefficients of the PHQ-A with CES-D and MFQ were 0.87 and 0.85, respectively (p < 0.01). By taking the iCGI-S as the remission criteria for MDD, the optimal cut-off value, sensitivity and specificity of the PHQ-A were 7, 98.7%, 94.7% respectively. CONCLUSION: The PHQ-A presented as a unidimensional construct and demonstrated satisfactory reliability and validity among the Chinese children and adolescents with MDD. A cut-off value of 7 was suggested for remission.


Assuntos
Transtorno Depressivo Maior , Psicometria , Humanos , Adolescente , Masculino , Feminino , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Reprodutibilidade dos Testes , Criança , China , Análise Fatorial , Questionário de Saúde do Paciente , Inquéritos e Questionários/normas , Escalas de Graduação Psiquiátrica/normas , Sensibilidade e Especificidade , Povo Asiático/psicologia , População do Leste Asiático
20.
J Affect Disord ; 356: 248-256, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38608769

RESUMO

This study uses time-intensive, item-level assessment to examine individual depressive and co-occurring symptom dynamics. Participants experiencing moderate-severe depression (N = 31) completed ecological momentary assessment (EMA) four times per day for 20 days (total observations = 2480). We estimated idiographic networks using MDD, anxiety, and ED items. ED items were most frequently included in individual networks relative to depression and anxiety items. We built ridge and logistic regression ensembles to explore how idiographic network centrality metrics performed at predicting between-subject depression outcomes (PHQ-9 change score and clinical deterioration, respectively) at 6-months follow-up. For predicting PHQ-9 change score, R2 ranged between 0.13 and 0.28. Models predicting clinical deterioration ranged from no better than chance to 80 % accuracy. This pilot study shows how co-occurring anxiety and ED symptoms may contribute to the maintenance of depressive symptoms. Future work should assess the predictive utility of psychological networks to develop understanding of how idiographic models may inform clinical decisions.


Assuntos
Comorbidade , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Projetos Piloto , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/epidemiologia , Avaliação Momentânea Ecológica , Depressão/psicologia , Depressão/epidemiologia , Ansiedade/psicologia , Ansiedade/epidemiologia , Escalas de Graduação Psiquiátrica
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