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1.
Health Aff (Millwood) ; 40(11): 1806-1810, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34724417

RESUMO

A health care leader shares her story of living with major depression and calls for better treatments.


Assuntos
Depressão , Transtorno Depressivo , Depressão/terapia , Feminino , Humanos
2.
Ann Palliat Med ; 10(10): 10896-10903, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34763451

RESUMO

BACKGROUND: This study sought to search, evaluate, and summarize the best evidence about the time and frequency of screening for perinatal depression (PND). METHODS: The UpToDate, Scottish Intercollegiate Network, National Institute for Health and Care Excellence, National Guideline Clearinghouse, Guidelines International Network, BMJ Best Practice, Cochrane Library, Embase, Campbell Collaboration, CINAHL, Joanna Briggs Institute Library, Medline, CNKI, Wanfang, VIP, and CBM databases were searched to retrieve relevant articles. RESULTS: A total of 9 articles were included in the meta-analysis, comprising 2 guidelines, 1 expert consensus, 1 evidence summary, 3 systematic reviews, and 2 clinical decisions. A total of 11 articles of best evidence were collected. The evidence was mainly related to the two aspects of screening time and frequency. CONCLUSIONS: There is abundant evidence on the best screening time for and frequency of PND; however, some evidence was from foreign evidence-based resources. Local clinical conditions need to be considered at the time of application.


Assuntos
Depressão , Transtorno Depressivo , Consenso , Feminino , Humanos , Programas de Rastreamento , Gravidez
6.
Saudi Med J ; 42(10): 1117-1124, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34611007

RESUMO

OBJECTIVES: To investigate the degree of public awareness, beliefs, and attitudes regarding major depression and available treatment options in the Saudi population. METHODS: A community-based cross-sectional study of 1,188 participants was carried out from March to April 2021 in Ha'il, Saudi Arabia using an online self-administered questionnaire. Using a snowball sampling technique, the authors targeted the Saudi population living in Ha'il region. RESULTS: Overall, 65.6% of the participants had good awareness regarding depression disorder in total. Of the participants, 72.9% had good awareness regarding general awareness, 85.4% regarding depression symptoms, 12.3% regarding risk factors, and 15.7% regarding treatments. Of the participants, 67.3% believed that depression was caused by lack of faith and 45.5% believed that depression was caused by "the evil eye" or black magic. Of the participants, 56% believed in faith healers as a legitimate treatment approach. Of the participants, 63.9% were willing to work with individuals with depression, 62.7% were willing to establish friendships with them, and 27.9% believed that individuals with depression had weak personalities. CONCLUSION: The general population exhibited good general awareness regarding depression and its symptoms, but knowledge of risk factors and treatments was poor. Our findings underscore the need for public educational programs to increase public awareness about the risk factors and treatment options for depression.


Assuntos
Transtorno Depressivo , Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/terapia , Humanos , Arábia Saudita/epidemiologia , Inquéritos e Questionários
7.
BMC Psychiatry ; 21(1): 504, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34649534

RESUMO

BACKGROUND: Up to one in eight women experience depression during pregnancy. In the UK, low intensity cognitive behavioural therapy (CBT) is the main psychological treatment offered for those with mild or moderate depression and is recommended during the perinatal period, however referral by midwives and take up of treatment by pregnant women is extremely low. Interpersonal Counselling (IPC) is a brief, low-intensity form of Interpersonal Psychotherapy (IPT) that focuses on areas of concern to service users during pregnancy. To improve psychological treatment for depression during pregnancy, the study aimed to assess the feasibility and acceptability of a trial of IPC for antenatal depression in routine NHS services compared to low intensity perinatal specific CBT. METHODS: We conducted a small randomised controlled trial in two centres. A total of 52 pregnant women with mild or moderate depression were randomised to receive 6 sessions of IPC or perinatal specific CBT. Treatment was provided by 12 junior mental health workers (jMHW). The primary outcome was the number of women recruited to the point of randomisation. Secondary outcomes included maternal mood, couple functioning, attachment, functioning, treatment adherence, and participant and staff acceptability. RESULTS: The study was feasible and acceptable. Recruitment was successful through scanning clinics, only 6 of the 52 women were recruited through midwives. 71% of women in IPC completed treatment. Women reported IPC was acceptable, and supervisors reported high treatment competence in IPC arm by jMHWs. Outcome measures indicated there was improvement in mood in both groups (Change in EPDS score IPC 4.4 (s.d. 5.1) and CBT 4.0 (s.d. 4.8). CONCLUSIONS: This was a feasibility study and was not large enough to detect important differences between IPC and perinatal specific CBT. A full-scale trial of IPC for antenatal depression in routine IAPT services is feasible. TRIAL REGISTRATION: This study has been registered with ISRCTN registry 11513120 . - date of registration 05/04/2018.


Assuntos
Terapia Cognitivo-Comportamental , Transtorno Depressivo , Aconselhamento , Depressão/terapia , Transtorno Depressivo/terapia , Feminino , Humanos , Gravidez , Resultado do Tratamento
8.
Trials ; 22(1): 731, 2021 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-34688307

RESUMO

BACKGROUND: After regular treatment, patients with persistent depressive disorder (PDD) may remain in specialized psychiatric outpatient care without achieving remission. Lacking other options, these patients often receive long-term, non-protocolized care as usual (CAU) that does not involve the partner/caregiver of the patient. Although the revised depression treatment guidelines suggest focusing on psychiatric rehabilitation and self-management as the next treatment step for PDD, an evidence-based cost-effective self-management protocol for PDD is lacking. This study investigates the "Patient and Partner Education Program for All Chronic Illnesses" (PPEP4All) as a brief self-management protocol that could lead to lower costs, higher quality of life, and less disease burden in PDD patients and their partners/caregivers. METHODS: Presented is the rationale and methods of a multicenter pragmatic randomized controlled trial to evaluate the clinical efficacy and cost-effectiveness of PPEP4All for patients with PDD and their partners/caregivers. In accordance with current recommendations, a mixed methods research approach is used with both quantitative and qualitative data. A total of 178 eligible outpatients with PDD and their partners/caregivers are recruited and randomized to either PPEP4All or CAU. Those assigned to PPEP4All receive nine weekly self-management sessions with a trained PPEP4All therapist. Primary and secondary outcome measurements are at 0, 3, 6, and 12 months. DISCUSSION: This project will result in the implementation of a self-management intervention for patients with PDD, meeting an urgent need in mental healthcare. Using PPEP4All can optimize the quality and efficiency of care for both patients with PDD and their partners/caregivers. TRIAL REGISTRATION: Netherlands Trial Register Identifier NTR5973 . Registered on 20 July 2016.


Assuntos
Transtorno Depressivo , Autogestão , Cuidadores , Análise Custo-Benefício , Humanos , Estudos Multicêntricos como Assunto , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
9.
Health Aff (Millwood) ; 40(10): 1612-1617, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34606357

RESUMO

Screening for perinatal depression is a clinical approach to identifying women in need of mental health diagnoses, referral, and treatment. Many states mandate screening for perinatal depression, but it remains unclear whether screening leads to increased access to treatment and better health outcomes. The aim of this qualitative study was to identify how women from diverse backgrounds perceive the quality of perinatal depression screening and whether the perceived quality affected their decisions about mental health care. During 2019 a sample of twenty-nine participants who had been screened for perinatal depression completed semistructured in-depth interviews in which they were asked for their impressions of the screening process. Common themes were that the screening was ineffective because providers didn't explain the purpose or uses of the screening tool, didn't tell patients anything about the results, and failed to provide any follow-up relating to patient depression scores. The results suggest the need for health care facilities to engage patients in a dialogue about screening results and for health care delivery systems to refine the screening process. These findings offer a foundation to design more comprehensive, patient-centered screening protocols that might result in improved mental health outcomes.


Assuntos
Depressão , Transtorno Depressivo , Depressão/diagnóstico , Feminino , Humanos , Programas de Rastreamento , Parto , Percepção , Gravidez , Pesquisa Qualitativa
10.
Health Aff (Millwood) ; 40(10): 1560-1565, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34606360

RESUMO

Untreated depression presents a distinct set of risks for pregnancy complications. Past studies have connected antenatal depression with adverse birth outcomes. The purpose of this study was to conduct an updated systematic review and meta-analysis examining the relationship between depression during pregnancy and associated adverse birth outcomes in US populations during the period 2010-20. As a trend, disparities in adverse pregnancy outcomes and maternal morbidities for Black pregnant people compared with those for White pregnant people continue to rise. Addressing mental health conditions during pregnancy has the potential to ameliorate a large and excessive burden on adverse birth outcomes among childbearing people and their offspring. Policy solutions to encourage, mandate, and reimburse universal depression screening during pregnancy are warranted.


Assuntos
Transtorno Depressivo , Complicações na Gravidez , Depressão/epidemiologia , Feminino , Humanos , Saúde Mental , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia
11.
Lancet Psychiatry ; 8(11): 991-1000, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34627532

RESUMO

Urbanisation and common mental disorders (CMDs; ie, depressive, anxiety, and substance use disorders) are increasing worldwide. In this Review, we discuss how urbanicity and risk of CMDs relate to each other and call for a complexity science approach to advance understanding of this interrelationship. We did an ecological analysis using data on urbanicity and CMD burden in 191 countries. We found a positive, non-linear relationship with a higher CMD prevalence in more urbanised countries, particularly for anxiety disorders. We also did a review of meta-analytic studies on the association between urban factors and CMD risk. We identified factors relating to the ambient, physical, and social urban environment and showed differences per diagnosis of CMDs. We argue that factors in the urban environment are likely to operate as a complex system and interact with each other and with individual city inhabitants (including their psychological and neurobiological characteristics) to shape mental health in an urban context. These interactions operate on various timescales and show feedback loop mechanisms, rendering system behaviour characterised by non-linearity that is hard to predict over time. We present a conceptual framework for future urban mental health research that uses a complexity science approach. We conclude by discussing how complexity science methodology (eg, network analyses, system-dynamic modelling, and agent-based modelling) could enable identification of actionable targets for treatment and policy, aimed at decreasing CMD burdens in an urban context.


Assuntos
COVID-19/psicologia , Transtornos Mentais/epidemiologia , Saúde Mental/normas , Saúde da População Urbana/normas , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Ecossistema , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Saúde Mental/tendências , Metanálise como Assunto , Prevalência , SARS-CoV-2/genética , Análise de Rede Social , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Análise de Sistemas , Saúde da População Urbana/tendências
12.
J Affect Disord ; 295: 946-953, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34706467

RESUMO

BACKGROUND: During previous pandemics people who use drugs (PWUD) were categorized among the most vulnerable. In the current study, firstly, we wanted to evaluate the impact of the COVID-19 crisis on the prevalence of anxiety and depressive disorders among PWUD. Furthermore, we wanted to compare the prevalence of these disorders with that of members from the general population who did not use drugs. METHODS: We used a matched cohort design based on two separate repeated cross-sectional online surveys (April and November 2020) among PWUD and the general population. Results of GAD-7 and PHQ-9 were used as outcome variables. We calculated absolute and relative risks for matched pairs for both affective disorders, and logistic regression to compare affective disorders over both waves for PWUD. RESULTS: In April, the prevalence of affective disorders was similar for PWUD and the general population. In November, the risks for anxiety disorders increased with 64% for PWUD compared to non-PWUD (RR = 1.64, 95%CI 1.42-1.88), whereas the risks for depressive disorders more than doubled (RR = 2.29, 95%CI 1.97-2.67). Having a job and being male were protective factors for PWUD for both anxiety and depressive disorders. LIMITATIONS: As this study used self-reported data, GAD-7 and PHQ-9 give an indication of the presence of anxiety and depression which might differ from a clinician's judgement. CONCLUSIONS: PWUD might be disproportionally affected by COVID-19. Health care providers should be attentive to substance use as an indicator for increased risk of mental health problems.


Assuntos
COVID-19 , Transtorno Depressivo , Preparações Farmacêuticas , Adulto , Ansiedade , Bélgica/epidemiologia , Estudos Transversais , Depressão , Transtorno Depressivo/epidemiologia , Humanos , Masculino , Pandemias , SARS-CoV-2
13.
J Affect Disord ; 295: 960-966, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34706469

RESUMO

BACKGROUND: Substance-induced psychosis has previously been linked to increased incidence of schizophrenia and bipolar disorder. We aimed to investigate if substance-induced psychosis is associated with increased risk of depression or anxiety. METHODS: We conducted a nationwide prospective register-based cohort study from 1994 to 2017, including all individuals with substance-induced psychosis, and age-and-sex matched controls without substance-induced psychosis. We investigated time to either depression or anxiety, as well as time to depression and time to anxiety, in stratified Cox regression models. RESULTS: We included 5,557 individuals with substance-induced psychosis and 55,562 controls. Substance-induced psychosis was associated with increased risk of either depression or anxiety (HR=7.05, 95% CI 6.71-7.41), depression (HR=5.40, 95% CI 4.77-6.11), or anxiety (HR=7.05, 95% CI 5.99-8.31). Analyses of individual types of substance-induced psychosis revealed similar hazard ratios across substances. Associations between substance-induced psychosis and depression or anxiety were stronger in people without preceding alcohol or substance use disorders. While strongest shortly after incident substance-induced psychosis, the increased incidence of depression and anxiety remained more than double over the full period of follow-up. LIMITATIONS: Only psychiatric disorders treated either in psychiatric inpatient or outpatient units, supplemented with information on psychiatric medication, was available. Exact times of onset were similarly unknown, and only dates of first treatment were available. CONCLUSIONS: Substance-induced psychosis is a strong predictor of later onset of depression or anxiety. Regardless of whether this association is causal, this highlights the need for increased monitoring and possibly improved treatment of patients with substance-induced psychosis.


Assuntos
Transtorno Depressivo , Transtornos Psicóticos , Transtornos de Ansiedade/epidemiologia , Estudos de Coortes , Transtorno Depressivo/epidemiologia , Humanos , Estudos Prospectivos , Transtornos Psicóticos/epidemiologia , Fatores de Risco
14.
Transl Psychiatry ; 11(1): 531, 2021 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-34657142

RESUMO

Several care models have been developed to improve treatment for depression, all of which provide "enhanced" evidence-based care (EEC). The essential component of these approaches is Measurement-Based Care (MBC). Specifically, Collaborative Care (CC), and Algorithm-guided Treatment (AGT), and Integrated Care (IC) all use varying forms of rigorous MBC assessment, care management, and/or treatment algorithms as key instruments to optimize treatment delivery and outcomes for depression. This meta-analysis systematically examined the effectiveness of EEC versus usual care for depressive disorders based on cluster-randomized studies or randomized controlled trials (RCTs). PubMed, the Cochrane Library, and PsycInfo, EMBASE, up to January 6th, 2020 were searched for this meta-analysis. The electronic search was supplemented by a manual search. Standardized mean difference (SMD), risk ratio (RR), and their 95% confidence intervals (CIs) were calculated and analyzed. A total of 29 studies with 15,255 participants were analyzed. EEC showed better effectiveness with the pooled RR for response of 1.30 (95%CI: 1.13-1.50, I2 = 81.9%, P < 0.001, 18 studies), remission of 1.35 (95%CI: 1.11-1.64, I2 = 85.5%, P < 0.001, 18 studies) and symptom reduction with a pooled SMD of -0.42 (95%CI: -0.61-(-0.23), I2 = 94.3%, P < 0.001, 19 studies). All-cause discontinuations were similar between EEC and usual care with the pooled RR of 1.08 (95%CI: 0.94-1.23, I2 = 68.0%, P = 0.303, 27 studies). This meta-analysis supported EEC as an evidence-based framework to improve the treatment outcome of depressive disorders.Review registration: PROSPERO: CRD42020163668.


Assuntos
Transtorno Depressivo , Transtorno Depressivo/terapia , Medicina Baseada em Evidências , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
15.
Artigo em Inglês | MEDLINE | ID: mdl-34639549

RESUMO

The aim of this study was the identification of the risk modifying factors of anxiety and depressive disorders based on a population study. This study was conducted in a randomly selected group of 1659 adult inhabitants of the Zywiec district. Anonymous questionnaires consisting of a proprietary questionnaire and the Hospital Anxiety and Depression Scale (HADS) were used to collect the data. The conducted analysis revealed that the factors increasing the risk of depressive disorders in the studied population were female gender, age over 60, retirement period, primary and vocational education, unemployment, mental work and absolute lack of physical activity, but also daily and intensive sports, heavy smoking, chronic somatic diseases and misuse of sleeping pills and over-the-counter sedatives. Anxiety disorders occurred more often in the group of unemployed, self-employed or retired people. They also occurred more often in the group of people who do not perform any physical activity and use alcohol every day, but also among those who maintain abstinence, regularly smoke tobacco and use stimulants, suffer from somatic diseases and overuse sleeping drugs. Disease preventive factors for anxiety disorders and depression were a constant form of employment, moderate and regular physical activity, avoiding the use of psychoactive substances and the regular treatment of comorbid somatic diseases and insomnia.


Assuntos
Transtorno Depressivo , Distúrbios do Início e da Manutenção do Sono , Adulto , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Inquéritos e Questionários
16.
Psychiatr Danub ; 33(Suppl 4): 541-545, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34718278

RESUMO

INTRODUCTION: Bipolar disorder (BD) is characterized by a high rate of prevalence in the general population varying from 0.6% to 5.84% (Yildiz 2015). BD is one of the leading causes of disability and mortality from suicide and comorbid diseases (Johnson et al. 2017). Individual symptoms of the disease in the form of cyclothymia-like mood fluctuations can be detected in adolescence and have potential for predicting risk for BD (Tijssen et al. 2010). The key issue here is untimely diagnosis of BD (Mosolov et al. 2014, Bardenshteyn et al. 2016). Early screening for risks of bipolar disorder at the preclinical stage. SUBJECTS AND METHODS: The study involved 137 students aged from 18 to 20 years (mean age 18.93±0.09). The clinical-psychopathological method as well as the screening method of research were used: the Mini-International Neuropsychiatric Interview (M.I.N.I.), (Sheehan et al. 1998), the Hamilton Depression Rating Scale (HDRS 1960), the Mood Disorder Questionnaire (MDQ) (Hirschfeld 2000). The statistical data processing included descriptive statistical methods (p<0.05). RESULTS: Clinical diagnostics of the responders using ICD-10 (WHO, 1992, Chapter V [F00-F99]) excluded the diagnosis of bipolar disorder. The MDQ screening method revealed a statistically significant excess of the average values for hypomania throughout the sample (M±m: 6.46±0.44; p<0.05). The total score of 64 interviewees (46.7%; 95% CI: 38.1-55.3) exceeded the threshold value (≥7). 68 responders (49.6%; 95% CI 41.0-55.3) showed one-stage manifestation of certain signs of mood rise. 72 interviewees (52.6%; 95% CI 43.9-58.3) reported absence of mood rise, associated with conflict behaviour, family problems etc. According to the HDRS scale, 45 responders (32.85%; 95% CI: 24.14-40.95) showed signs of mild depression (M±m: 6.51±0.39; p<0.05). Also, a group of responders (18.2%; 95% CI: 11.78-24.72) manifested exceeding indicators both for hypomania and depression. CONCLUSIONS: According to the MDQ scale, 46.7% of the responders showed threshold values exceeding; with the one-stage manifestation of hypomania signs in 49.6% of the respondents. 32.85% of the responders showed signs of mild depression (the HAMD scale). 18.2% of the interviewees exceeded threshold values for both hypomania and depression. The discovered cyclothymia-like conditions at the preclinical stage have potential for predicting risk for their transformation to bipolar disorder which directs further outpatient clinical and dynamic observation.


Assuntos
Transtorno Bipolar , Transtorno Depressivo , Adolescente , Adulto , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/epidemiologia , Transtorno Ciclotímico , Humanos , Programas de Rastreamento , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Adulto Jovem
17.
Psychiatr Danub ; 33(Suppl 4): 738-744, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34718311

RESUMO

BACKGROUND: The purpose of this study was to examine the relationship between the important indicators that define mental health functioning during the first pregnancy: the level of depression, anxiety and fear of childbirth in the context of nulliparas' intimate partner attachment style type and older generation's emotional support. SUBJECTS AND METHODS: A group of 325 nulliparas in the third trimester of pregnancy were enrolled at the Childbirth preparation program of the University Medical Centre Ljubljana's Division of Gynaecology and Obstetrics. The following instruments were applied: Experiences in Close Relationships-Revised, The Edinburgh Depression Scale, two aspects of anxiety - Zung Anxiety Scale and a questionnaire regarding fear of childbirth. Attachment anxiety and avoidance scales were recoded into four categories of a prototypical attachment style: secure, fearful, preoccupied and dismissive. Two-way ANOVA and the chi-square test were used for the statistical analysis. RESULTS: All indicators of mental health functioning of our sample of nulliparas differed significantly regarding their partner attachment style. Nulliparas with a fearful, but also with a preoccupied type of attachment, showed less optimal mental health indicators compared to those with a secure/dismissive type of attachment. A significant interactive effect of partner attachment and emotional support from the older generation was found on the level of depression. Partner attachment styles and emotional support from the older generation were found to be statistically dependent. CONCLUSIONS: In our sample a secure attachment seems to represent a protective buffer for the level of depression, even when a lower emotional support of the older generation was included. Screening and intervening on intimate attachment style as a protective factor for antenatal depression and different forms of anxiety is proposed.


Assuntos
Depressão , Transtorno Depressivo , Ansiedade , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Relações Interpessoais , Apego ao Objeto , Gravidez
18.
BMJ Open ; 11(10): e048764, 2021 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635517

RESUMO

INTRODUCTION: Perinatal depression is common and can often lead to adverse health outcomes for mother and child. Multiple pharmacological and non-pharmacological treatments have been evaluated against usual care or placebo controls in meta-analyses for preventing and treating perinatal depression compared. It is not yet established which of these candidate treatments might be the optimal approach for prevention or treatment. METHODS AND ANALYSIS: A systematic review and Bayesian network meta-analyses will be conducted. Eight electronic databases shall be searched for randomised controlled trials that have evaluated the effectiveness of treatments for prevention and/or treatment of perinatal depression. Screening of articles shall be conducted by two reviewers independently. One network meta-analysis shall evaluate the effectiveness of interventions in preventing depression during the perinatal period. A second network meta-analysis shall compare the effectiveness of treatments for depression symptoms in women with perinatal depression. Bayesian 95% credible intervals shall be used to estimate the pooled mean effect size of each treatment, and surface under cumulative ranking area will be used to rank the treatments' effectiveness. ETHICS AND DISSEMINATION: We shall report our findings so that healthcare providers can make informed decisions on what might be the optimal approach for addressing perinatal depression to prevent cases and improve outcomes in those suffering from depression through knowledge exchange workshops, international conference presentations and journal article publications. PROSPERO REGISTRATION NUMBER: CRD42020200081.


Assuntos
Depressão , Transtorno Depressivo , Teorema de Bayes , Criança , Depressão/prevenção & controle , Transtorno Depressivo/prevenção & controle , Feminino , Humanos , Metanálise como Assunto , Metanálise em Rede , Gravidez , Revisões Sistemáticas como Assunto , Resultado do Tratamento
19.
PLoS One ; 16(10): e0256553, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34648497

RESUMO

Depression in the workplace is a significant factor for reduced personal well-being and productivity. Consequently, this has negative effects on the economic success of the companies in which depressed people are employed. In addition, the economy has to deal with the significant burden of this illness on the health system. In this paper, we investigated how different working contexts-working in a group or individually-influenced depressed individuals towards higher or lower well-being and productivity. We examined this using a laboratory experiment. In this setting, we were also able to analyze how, in turn, a depressive individual impacted the productivity and affective situation of their workgroup, reflecting the company perspective. The experimental design mimicked the very basic processes of a workplace in a stylized way. We used two distinct samples: subclinically and clinically depressed, both working in a group with healthy controls. As expected, we found generally lower performance in the clinically depressed sample, but in the subclinically depressed sample, we only found this in the individual work context. In contrast to our expectations, the performance of subclinically depressed individuals working in groups with healthy controls was even higher than that of healthy controls in homogenously healthy groups. The performance of the entire group with a depressed member was lower for the sample with clinically manifested depression, while the performance of groups with a subclinically depressed participant was significantly higher than the performance of homogeneously non-depressed control groups. We discuss our results with a focus on the design of workplaces to both re-integrate clinically depressed employees and prevent subclinically depressed employees from developing major depression.


Assuntos
Comportamento Cooperativo , Depressão/psicologia , Transtorno Depressivo/psicologia , Eficiência , Relações Interpessoais , Local de Trabalho , Adulto , Afeto , Feminino , Voluntários Saudáveis/psicologia , Humanos , Masculino , Qualidade de Vida/psicologia , Adulto Jovem
20.
Asian J Psychiatr ; 66: 102890, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34717110

RESUMO

BACKGROUND: Edinburgh Postnatal Depression Scale (EPDS) is a validated screening tool widely used to assess perinatal depression (PND). However, due to stigma associated with PND, respondents could answer sensitive questions differently depending on the mode of administration, especially in culturally and linguistically diverse country like India. The present study explored longitudinal differences in EPDS scores between self-administered and interviewer-administered modes. METHODS: 177 women from rural South India were administered EPDS, self-administration followed by interviewer-administered for four visits, twice each during prenatal and postnatal visits. EPDS scores were compared between the two modes descriptively, graphically and by repeated mixed measure models. Classification of antenatal depression (AD), postnatal depression (PD) and PND based on the two modes were compared by McNemar Chi-square test. Clinical and psychosocial characteristics were examined to identify factors associated with differences in the scoring modes. Concordance rates and Goodman Kruskal's Gamma coefficients were measured for individual EPDS items. RESULTS: Longitudinal EPDS scores and rates of AD, PD and PND were significantly higher in self-administered mode. Recent adverse life events were the only factor observed to be significantly associated with the differences between the two modes. Rank correlation and concordance rates suggested stronger association for EPDS items relating to anhedonia subscale and moderate/weaker association for EPDS items relating to anxiety/depression subscales. CONCLUSION: Our study findings suggest that the effect of mode of administration should be taken into account while using PND screening tools such as EPDS, especially in countries such as India with higher levels of illiteracy.


Assuntos
Depressão Pós-Parto , Transtorno Depressivo , Depressão , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Programas de Rastreamento , Gravidez , Escalas de Graduação Psiquiátrica
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