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2.
Artigo em Russo | MEDLINE | ID: mdl-31793544

RESUMO

AIM: To assess spatial working memory disorders in patients with mild depressive disorders and determine their neurophysiological correlates. MATERIAL AND METHODS: Thirty patients (right-handed) with ICD-10 diagnosis Mood Disorders (F31.3, F32.0, F33.0, F34.1), aged 37±8 years, were examined before treatment. A control group included 30 mentally and somatically healthy individuals (32±7 years old). The study of spatial working memory was carried out using the Corsi Block-Tapping test. EEG was recorded and the values of the spectral power of theta, alpha and beta rhythms were analyzed. RESULTS AND CONCLUSION: A decrease in the level of working memory that was correlated with higher values of theta rhythm power in the frontal and occipital regions and alpha rhythm in the frontal cortex was observed in affective disorders with mild depressive symptoms.


Assuntos
Transtorno Depressivo , Transtornos da Memória , Memória de Curto Prazo , Adulto , Depressão , Transtorno Depressivo/complicações , Transtorno Depressivo/fisiopatologia , Eletroencefalografia , Humanos , Transtornos da Memória/complicações , Pessoa de Meia-Idade , Transtornos do Humor , Ritmo Teta
3.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(11): 116-122, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31851182

RESUMO

Anhedonia is one of the core features of depression. The article considers the place of anhedonia in the structure of affective disorders, its influence on the prognosis and effectiveness of therapy. The authors stress that various manifestations of anhedonia must be considered in correlation with the basic ability to feel pleasure. Therapy of anhedonia is not always effective. According to literature, agomelatin occupies a leading position among the drugs that reduce anhedonia.


Assuntos
Anedonia , Transtorno Depressivo , Depressão/complicações , Depressão/diagnóstico , Transtorno Depressivo/complicações , Transtorno Depressivo/diagnóstico , Emoções , Humanos , Prognóstico
4.
J Consult Clin Psychol ; 87(10): 952-961, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31556671

RESUMO

OBJECTIVE: This retrospective study describes the role of behavioral health in an addiction medicine program integrated in a primary care clinic, and evaluates retention, substance use, and mental health symptoms for patients in a rural underserved community. METHOD: Data were abstracted from records of patients referred for buprenorphine treatment of opioid use disorder (N = 101; 45% female, 23% Native Hawaiian or Pacific Islander, Mage = 42.5, SD = 12.75). Among patients prescribed buprenorphine (n = 61), most had comorbid substance-related diagnoses (72% with tobacco use, 75% with at least one other substance use disorder) and non-substance-related mental health diagnoses (77%), most commonly depression and anxiety. Integrated sessions with a behavioral health provider and a buprenorphine-waivered prescriber occurred weekly to monthly. Participants completed depression and anxiety questionnaires (Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7) and provided urine samples at each visit. RESULTS: Most patients (72%) were retained for at least 3 months, with early dropout associated with higher initial depression and anxiety scores. Inconsistent urine drug tests (i.e., those positive for illicit/nonprescribed substances) were significantly more common at treatment initiation (74%) than during the most recent visit (43%, p < .001), and were associated with baseline substance and other mental health factors, as well as shorter treatment duration. Generalized estimating equations models suggested time-based improvements in depression and anxiety symptoms, especially for patients retained for at least 3 months. CONCLUSIONS: Integrating wraparound addiction treatment within a rural primary care setting is feasible and associated with improved mental health and retention outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Medicina do Vício , Buprenorfina/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Atenção Primária à Saúde , Saúde da População Rural , Adulto , Transtornos de Ansiedade/complicações , Buprenorfina/administração & dosagem , Transtorno Depressivo/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas de Entorpecentes/administração & dosagem , Transtornos Relacionados ao Uso de Opioides/complicações , Estudos Retrospectivos
5.
Tijdschr Psychiatr ; 61(9): 635-643, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31560783

RESUMO

BACKGROUND: Antidepressants remain controversial, partly due to allegations that disappointing results were buried and because of their modest average efficacy.
AIM: To investigate bias in the antidepressant literature and the possibilities for predicting which patients with depression or anxiety do receive significant benefits from antidepressants.
METHOD: We investigated bias by comparing information from the US Food and Drug Administration with the published literature. To predict response, we used patient data from randomized trials.
RESULTS: Of all studies on depression or anxiety, 50% and 72% were positive, compared to 95% and 96% of all published studies. Safety outcomes were poorly reported in published articles and unpublished studies were often 'bundled' into pooled-trials publications with positive conclusions. We found an association between severity and antidepressant efficacy for some, but not all, anxiety disorders; previous research has found inconsistent evidence for this association for depression. Furthermore, patients with depression that showed early improvement were more likely to attain a good response, irrespective of which symptoms improved.
CONCLUSION: These results demonstrate the severe impact of bias on the antidepressant literature. Severity and early improvement predicted a good response, but more information is needed to improve predictions. The increased accessibility of individual patient data will hopefully soon enable further progress in this area.


Assuntos
Antidepressivos/uso terapêutico , Transtornos de Ansiedade/tratamento farmacológico , Transtorno Depressivo/tratamento farmacológico , Transtornos de Ansiedade/complicações , Transtorno Depressivo/complicações , Diagnóstico Duplo (Psiquiatria) , Medicina Baseada em Evidências , Humanos , Resultado do Tratamento
6.
Maturitas ; 128: 4-9, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31561821

RESUMO

INTRODUCTION: It is uncertain whether depression and exposure to antidepressants increase the risk of cardiovascular events in later life. This study attempts to clarify whether the risk of cardiovascular events associated with exposure to antidepressant medications varies according to history of depression. METHODS: Cohort study of 5522 Australian men aged 70-89 years living in the metropolitan region of Perth, Western Australia, who were followed for novel cardiovascular events over 12 years. Clinical diagnoses followed the International Classification of Diseases (ICD) codes for ischaemic heart disease, cerebrovascular events and depressive disorders. Participants self-reported their use of medications. Other study measures included age, schooling, smoking history and the following concurrent morbidities: diabetes, hypertension, cancer, dementia, and respiratory diseases, gastrointestinal and renal diseases. RESULTS: 374 men (6.8%) had a recorded or current diagnosis of depression and 365 (6.6%) were using an antidepressant. Prevalent depression and antidepressant use were associated with increased mortality hazard, but not the interaction between them (hazard ratio, HR = 0.46, 95%CI = 0.33, 0.65). Depression (HR = 1.50, 95%CI = 1.21, 1.86) and antidepressants (HR = 1.52, 95%CI = 1.20, 1.93) were associated with an increased risk of cardiovascular events, but the interaction term was associated with decreased risk (HR = 0.51, 95%CI = 0.30, 0.87). All analyses were adjusted for other study measures. DISCUSSION: Depression and antidepressant use were associated with an increase in the 12-year risk of cardiovascular events, while antidepressants were associated with a decrease in the risk of cardiovascular events among older men with depression, but not among those without. This suggests that the effect of this interaction on the risk of cardiovascular events may be driven by the ability of antidepressants to lead to clinical improvements in mood.


Assuntos
Antidepressivos/uso terapêutico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Antidepressivos/efeitos adversos , Estudos de Coortes , Depressão/complicações , Depressão/tratamento farmacológico , Transtorno Depressivo/complicações , Transtorno Depressivo/tratamento farmacológico , Humanos , Classificação Internacional de Doenças , Masculino , Prevalência , Fatores de Risco , Austrália Ocidental/epidemiologia
7.
Psychiatr Danub ; 31(Suppl 3): 619-621, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488802

RESUMO

A recent meta-analysis including data from 22 studies including 2.9 million patients found that anxiety and depression are more prevalent in patients with dry eye disease (DED) than in controls. DED is a common disorder of the tear film which can cause ocular irritation, foreign body sensation and visual disturbance. However there is often a great discrepancy between signs and symptoms of DED, which the symptoms often being more associated with non-ocular disorders such as depression and PTSD than to tear film parameters. In this way it could be considered as more of a psychiatric than ophthalmic complaint. DED and depression feedback on one another in a synergistic manner. Severity of DED is associated with symptoms of anxiety and depression. Treatment of DED could help reduce depression symptoms, but also effective management of depression could help alleviate symptoms of DED. Complicating this however is the evidence that SSRIs can exacerbate DED. This makes the management of these comorbidities more difficult, however there are putative therapeutic targets which may be a source of future treatments for DED-associated depression. In conclusion, it is clear that DED and depression are closely linked and influence one another in ways that drastically affect patients' lives. Collaboration between psychiatrists and ophthalmologists could be beneficial in the management of those with DED.


Assuntos
Depressão/complicações , Transtorno Depressivo/complicações , Síndromes do Olho Seco/complicações , Ansiedade/complicações , Síndromes do Olho Seco/fisiopatologia , Humanos , Metanálise como Assunto , Lágrimas/fisiologia
8.
Biomed Res Int ; 2019: 3617129, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31467884

RESUMO

Background: Accumulating evidence from prospective epidemiological studies has showed that depression disorder (DD) is a risk factor for cancer. The aim of this study is to explore the association of DD and the overall occurrence risk of hepatocellular carcinoma (HCC) and the mechanism. Methods: In this study, 60 mice were randomly divided into four groups: Control group, DD group, HCC group, HCC-DD group. Mice received a chronic dose of reserpine to establish depression model, followed by Diethylnitrosamine and Carbon tetrachloride administration to establish HCC models. Behavioral depression was assessed by sucrose preference test (SPT) and the expression of Serotonin 1A (5-HT1A) receptor in the hippocampal. The expression of Oatp2a1 and Oatp2b1 in the digestive system tissues was detected by PCR and western blotting. Results: Reserpine-administrated mice had a reducing sucrose preference at Day 14 compared with blank mice (P<0.05). The expression of 5-HT1A receptor in the hippocampal was decreased in DD mice compared with blank mice. The survival analysis indicated that the HCC mice with DD have poorer survival rate compared with the HCC mice. Compared with HCC mice, the expression of Oatp2a1 and Oatp2b1 was lower in liver and stomach tissue and higher in hepatic carcinoma and colon tissue of HCC-DD mice (P<0.05), and the expression of Oatp2a1 was higher in the spleen tissue of HCC-DD mice while the expression of Oatp2b1 was lower (P<0.05). However, no difference was found in the expression of Oatp2a1 and Oatp2b1 in the small intestine tissue between HCC group and HCC-DD group. Conclusions: DD was the adverse factors for the overall occurrence risk of HCC. Mechanistically, be the downregulation of Oatp2a1 and Oatp2b1 in liver tissue induced by DD might be involved.


Assuntos
Carcinoma Hepatocelular/genética , Transtorno Depressivo/genética , Neoplasias Hepáticas/genética , Transportadores de Ânions Orgânicos/genética , Animais , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/patologia , Transtorno Depressivo/complicações , Transtorno Depressivo/patologia , Modelos Animais de Doenças , Regulação Neoplásica da Expressão Gênica , Humanos , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/patologia , Camundongos , Fatores de Risco
9.
J Korean Med Sci ; 34(30): e199, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31373184

RESUMO

BACKGROUND: Recent studies have indicated the significant association between non-alcoholic fatty liver disease (NAFLD) and depression. However, there is ongoing debate on whether the risk for depression is actually related with the presence and severity of NAFLD. Thus, this study was conducted to investigate the association between depression and NAFLD evaluated by diverse modalities. METHODS: A total of 112,797 participants from the Korean general population were enrolled. The study participants were categorized into three groups according to degree of NAFLD evaluated by ultrasonography, fatty liver index (FLI) and fibrosis-4 score (FIB-4). Depression was defined as a score of Center for Epidemiological Studies-Depression (CES-D) ≥ 16, and the odd ratios (ORs) and 95% confidence interval (CI) for depression (adjusted ORs [95% CI]) were assessed by multiple logistic regression analyses. RESULTS: In the unadjusted model, the presence and severity of NAFLD was not significantly associated with depressive symptoms. However, in the fully adjusted model, ORs for depression increased in proportion to the degree of ultrasonographically detected NAFLD (mild fatty liver: 1.14 [1.06-1.22]; and moderate to severe fatty liver: 1.32 [1.17-1.48]). An association was also observed between depression and FLI (30 ≤ FLI < 60: 1.06 [0.98-1.15]; FLI ≥ 60: 1.15 [1.02-1.29]). CONCLUSION: The presence and severity of NAFLD is significantly associated with depressive symptoms. In addition, this association was more distinct after adjusting for covariates including age, gender and insulin resistance. This finding indicates the necessity of further study evaluating the incidental relationship of depression with NAFLD.


Assuntos
Transtorno Depressivo/diagnóstico , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Adulto , Transtorno Depressivo/complicações , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/patologia , Razão de Chances , República da Coreia/epidemiologia , Índice de Gravidade de Doença , Ultrassonografia
10.
Artigo em Russo | MEDLINE | ID: mdl-31464293

RESUMO

AIM: To clarify the role of depressive disorders and personality traits in the pathogenesis of diabetes mellitus type I in children and adolescents. MATERIAL AND METHODS: One hundred and three patients with diabetes, aged from one year nine months to 17 years, mean 9.7±0.7), with diabetes mellitus and depressive disorders were studied using clinical-psychopathological, psychometric, paraclinical and statistical methods. RESULTS: Biological and psychosocial risk factors of a somatic disorder have been identified. Mental disorders are represented by affective disorders and personality features of the patients. Affective disorders include mild psychogenic anxiety and asthenic-anxiety depression, personality features are represented by hysterical signs and emotional lability. Clinical variants of these mental disorders and their diagnostic assessment according to ICD-10 are presented. CONCLUSION: The dynamics of diabetes mellitus correlate with characteristics of depressive disorders. This result can be used to optimize the therapy of diabetes mellitus.


Assuntos
Transtorno Depressivo , Complicações do Diabetes , Adolescente , Ansiedade , Criança , Pré-Escolar , Depressão , Transtorno Depressivo/complicações , Humanos , Lactente , Transtornos do Humor , Transtornos da Personalidade
11.
Artigo em Russo | MEDLINE | ID: mdl-31464295

RESUMO

The authors discuss the relationship between depression and cognitive impairment in the aspect of mechanisms of their development, variants of comorbidity and recommendations on differentiated therapy in elderly. The diagnostic differentiation between depression and dementia at different stages of dementia as well as in younger and older ages, a role of depression as a risk factor for dementia, a role of other factors, in particular age, as well as treatment approaches on the example of antidepressants and cerebrolysin are considered.


Assuntos
Disfunção Cognitiva , Demência , Depressão , Transtorno Depressivo , Idoso , Antidepressivos/uso terapêutico , Disfunção Cognitiva/complicações , Depressão/complicações , Depressão/tratamento farmacológico , Transtorno Depressivo/complicações , Transtorno Depressivo/tratamento farmacológico , Humanos , Pessoa de Meia-Idade
13.
Psiquiatr. biol. (Internet) ; 26(2): 62-65, mayo-ago. 2019.
Artigo em Espanhol | IBECS | ID: ibc-185032

RESUMO

La anosognosia es una característica común pero variable en la enfermedad de Alzheimer (EA). Se define como la incapacidad de introspección del paciente respecto a los déficits cognitivos y a las alteraciones del comportamiento. La anosognosia podría considerarse como un fenómeno temprano de la EA, pero debido a su carácter multifactorial existen dificultades en el proceso de detección, al no existir pruebas estandarizadas. Se presenta un caso clínico de una mujer de 57años con antecedentes de trastorno depresivo que ingresa por conductas bizarras, desorganizadas, lenguaje escaso y sin déficits cognitivos relevantes. A nivel clínico no se aprecia sintomatología afectiva o psicótica, siendo lo más relevante la presencia por parte de la paciente de anosognosia de cualquier alteración de conducta. La evolución tórpida y los resultados de la tomografía computarizada por emisión de fotón único (SPECT) y el líquido cefalorraquídeo orientan a un estadio preclínico de la EA, previo a la presencia de deterioro cognitivo. La anosognosia como síntoma orientador en el inicio de la EA puede ayudar a realizar un diagnóstico y abordaje terapéutico precoz de la EA


Anosognosia is a common but variable feature in Alzheimer's disease (AD). It is defined as the lack of awareness of the patient as regards cognitive deficits and behavioural alterations. Anosognosia could be considered as an early phenomenon of AD, but due to its multifactorial nature there are difficulties in the detection process, as there are no standardised tests. A clinical case is presented of a 57year-old woman with a history of depressive disorder, who was admitted for bizarre and disorganised behaviour and poor language, but no relevant cognitive deficits. At the clinical level, there were no affective or psychotic symptoms, with the most relevant signs being the presence of anosognosia in any behaviour changes by the patient. The lack of progression, the single photon emission computed tomography (SPECT), and cerebrospinal fluid results, pointed to a pre-clinical stage of AD, prior to the presence of cognitive impairment. Anosognosia as a guiding symptom in the onset of AD can help to make an early diagnosis and provide an early therapeutic approach to AD


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Doença de Alzheimer/diagnóstico , Transtornos Cognitivos/diagnóstico , Transtornos do Comportamento Social/diagnóstico , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Transtorno Depressivo/complicações , Líquido Cefalorraquidiano/citologia
14.
Rev Assoc Med Bras (1992) ; 65(6): 801-809, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340308

RESUMO

BACKGROUND: Depression and anxiety disorders (DAD) are the most prevalent mental health conditions worldwide. Among the adult population served in basic care, it is estimated that depression affects about 14.3% of these individuals worldwide, and between 21.4% and 31% in Brasil. Anxiety affects up to 33.7% of the population during their lifetimes. OBJECTIVES: estimate the prevalence proportions of DAD among patients in a municipality in Northeast Brasil and study the association between DAD and cardiovascular risk factors. METHODS: a cross-sectional study with the medical records of patients from primary care centers in Jaboatão dos Guararapes, Pernambuco. Patients aged ≥ 18 years and regularly followed-up were included. Exclusion criteria: a history of traumatic brain injury, alcohol or drug abuse, previous stroke, medical conditions or medications that mimic DAD symptoms. Subjects were divided into two groups depending on the presence or absence of DAD, and cardiovascular risk factors were compared between groups. RESULTS: A total of 1030 subjects were initially included, of whom 215 (20%) were excluded. No-DAD subjects had more history of myocardial infarction and alcoholism. The prevalence of depression was 10.3%, anxiety disorder was 27.1%, and mixed DAD represented 4.5%. There was a significant association between DAD and hypertension (OR = 2.11; 95%CI: 1.16 -3.84; p=0.01), obesity (OR = 4.47; 95%CI: 1.74 -11.46; p=0.002), and hyperlipidemia (OR = 3.88; 95%CI: 1.81-8.3; p<0.001). CONCLUSION: DAD were associated with an increased risk for arterial hypertension, obesity, and hyperlipidemia.


Assuntos
Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/epidemiologia , Atenção Primária à Saúde/estatística & dados numéricos , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Estatísticas não Paramétricas
15.
Artigo em Russo | MEDLINE | ID: mdl-31317903

RESUMO

AIM: To study structural correlates of apathy in patients with late-life depression. MATERIAL AND METHODS: Thirty-five patients (≥60 y.o.) with late-onset depression and 22 age-matched healthy volunteers underwent high resolution brain MRI-scanning, and a comprehensive neuropsychiatric examination including HAM-D and the Apathy Scale. RESULTS AND CONCLUSION: A morphometric analysis showed that apathy was associated with atrophy of the lateral prefrontal cortex and reduced grey matter volume of the caudate nucleus on the right, and the nucleus accumbens on the left. Depression correlated with reduced thickness of the medial orbitofrontal cortex bilaterally, rostral anterior cingulate gyrus on the left, isthmus cingulate gyrus on the right, and larger surface area of the entorhinal cortex. Total grey matter volume, grey/white matter volumes of the cerebellum, and cortical thickness in temporal and occipital regions were negatively correlated with both apathy and depression severity. Thus, atrophy of basal ganglia and lateral prefrontal cortex, well known neuroanatomical correlates of apathy in different psychiatric and neurological conditions, characterized it in late-life depression too. This supports the idea of independent pathophysiology of apathetic syndrome.


Assuntos
Apatia , Depressão , Transtorno Depressivo , Substância Branca , Encéfalo/diagnóstico por imagem , Depressão/complicações , Depressão/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/psicologia , Giro do Cíngulo , Humanos , Imagem por Ressonância Magnética
16.
J Korean Acad Nurs ; 49(3): 225-240, 2019 Jun.
Artigo em Coreano | MEDLINE | ID: mdl-31266920

RESUMO

PURPOSE: The purpose of this study was to evaluate the effects of reminiscence therapy on depressive symptoms in older adults with dementia using a systematic review and meta-analysis. METHODS: Randomized controlled trials (RCTs) published from January 2000 to January 2018 were searched through Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), Korean Medical Database (KMbase), KoreaMed, PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Ovid MEDLINE. Two researchers independently performed the search, selection, and coding. Comprehensive Meta-Analysis 3.0 was used for meta-analysis, and Review Manager program 5.3 was used for quality assessment. RESULTS: Out of the 1,250 retrieved articles, 22 RCTs were selected for analysis. The overall effect size of reminiscence therapy for mitigating depressive symptoms in older adults with dementia was -0.62 (95% Cl: -0.92 to -0.31). The effect size was greater in older adults under 80, those with less disease severity, and those for whom the therapy session lasted less than 40 minutes. CONCLUSION: Reminiscence therapy is an effective non-pharmacological therapy to improve depressive symptoms in older adults with dementia. Because its effectiveness is also influenced by age, disease severity, and application method, it is necessary to consider treatment designs based on individual characteristics as well as methodological approaches.


Assuntos
Demência/diagnóstico , Transtorno Depressivo/terapia , Idoso , Bases de Dados Factuais , Demência/complicações , Transtorno Depressivo/complicações , Transtorno Depressivo/diagnóstico , Humanos , Rememoração Mental , Psicoterapia
17.
Nord J Psychiatry ; 73(6): 340-348, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31259640

RESUMO

Purpose: This study examined a developmental model that links affect-regulation difficulties in childhood with three dimensions of alexithymia in adolescence (difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking) and substance use and depression in adulthood, while accounting for cumulative contextual risk in childhood, and testing potential gender moderation. Methods: Multiple group path analyses were conducted using data from the Northern Finland Birth Cohort 1986 (N = 6963). Analyses used data collected during prenatal/birth, childhood, adolescence, and young adulthood periods. Results: Our examination of early precursors for alexithymia indicated that the associations of affect-regulation problems in childhood with alexithymia were stronger for girls, potentially putting girls with affect-regulation difficulties in childhood at higher risk for developing alexithymia in adolescence. The associations of cumulative contextual risk in childhood with alexithymia, substance use disorder, and depression diagnosis in adulthood were significant for both girls and boys. Our findings in regard to substance use and depression disorders revealed that alexithymia in adolescence predicted depression diagnosis in adulthood, particularly due to a contribution from the alexithymia domain of 'difficulties identifying feelings.' However, none of the alexithymia domains was directly associated with substance use disorder in adulthood. Conclusions: Our study contributes to research that links alexithymia with difficulties in affect regulation and cumulative contextual risk in childhood, yielding findings that may be relevant for preventive interventions.


Assuntos
Sintomas Afetivos/complicações , Depressão/complicações , Transtorno Depressivo/complicações , Psicologia do Adolescente , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Adulto , Criança , Estudos de Coortes , Emoções , Feminino , Finlândia , Humanos , Masculino , Gravidez , Adulto Jovem
18.
Z Psychosom Med Psychother ; 65(2): 198, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31154929

RESUMO

Long-term effectiveness of psychodynamic inpatient therapy on depressive disorders - Catamnestic- Results of the STOP-D-Study Objectives: Depression is one of the most common disorders with a rate of recurrence between 60-75 %. The effectiveness of psychodynamic therapy is well-proven, but there is still a lack of studies proving the long-term effectiveness of inpatient treatment on depressive symptom load. Methods: After psychodynamic inpatient treatment in a psychodynamically oriented psychosomatic hospital unit, the reduction in general and depressive symptom load (e. g. BDI, HAMD, SCL-90-R) was evaluated by a six-month follow up design. The study was set up as naturalistic multicenter intervention study including a female follow-up sample (N = 291; age 25-45 years). Results: The symptom improvement reached by the inpatient treatment remained stable at the follow-up survey. Patients treated with antidepressant medication showed stronger depressive symptom load at discharge and follow-up survey compared to patients without antidepressant medication. Sociodemographic variables and a comorbid personality disorder were not associated with increased drop-out rates, but depressive symptom load and a premature ending of the treatment. Conclusions: The obtained results demonstrate the long-term effectiveness of inpatient psychodynamic psychotherapy. Further studies about the influence of post-hospital psychotherapy and medical treatment as well as patient satisfaction seem necessary.


Assuntos
Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Pacientes Internados/psicologia , Psicoterapia Psicodinâmica , Adulto , Depressão/complicações , Depressão/psicologia , Depressão/terapia , Transtorno Depressivo/complicações , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/complicações , Fatores de Tempo , Resultado do Tratamento
19.
Turk Psikiyatri Derg ; 30(1): 16-22, 2019.
Artigo em Turco | MEDLINE | ID: mdl-31170303

RESUMO

OBJECTIVE: Psychiatric differential diagnosis is often ignored in young patients with memory complaints, even if no neurological or physical illnesses were evident. In this study, we aimed to determine the relationship between subjective memory complaints and objective memory impairment, depression and anxiety levels in young patients with memory complaints.  METHOD: The study was carried out with 56 patients under the age of 55 who applied to the psychiatry, neurology and internal medicine outpatient clinics with memory complaints and 55 healthy volunteers. All participants completed the Subjective Memory Complaints Questionnaire (SMCQ), the Montreal Cognitive Assessment (MoCA), the Auditory Verbal Learning Test (AVLT), the Benton Visual Memory Test (BVMT), the Digit Span Test (DST), the Verbal Fluency Test (VFT), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI).  RESULTS: Significant differences were observed in the scores of SMCQ, MoCA, AVLT, BVMT, DST, VFT, BDI and BAI in individuals with memory complaints compared to the controls, which could not be ascribed to any neurological or physical disease. Depression and anxiety levels were significantly higher than those of the control group.  CONCLUSION: Differential diagnosis of memory complaints has to be made in young patients. Subjective memory complaints may be indicative of depression and anxiety disorders. It is necessary to evaluate the cognitive impairment that may develop over time in young patients with subjective memory disturbances via longitudinal studies.


Assuntos
Transtorno Depressivo/psicologia , Transtornos da Memória/psicologia , Adulto , Fatores Etários , Estudos de Casos e Controles , Transtorno Depressivo/complicações , Feminino , Humanos , Masculino , Transtornos da Memória/complicações , Pessoa de Meia-Idade , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Adulto Jovem
20.
Plast Reconstr Surg ; 144(1): 24-33, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31246794

RESUMO

BACKGROUND: Revision procedures address contour irregularities and aesthetic concerns following autologous breast reconstruction. Mental health diagnoses are known to influence patient satisfaction with reconstruction. The authors aimed to identify oncologic, reconstructive, and demographic factors, including mental health diagnoses, associated with the number of revisions after autologous breast reconstruction. METHODS: The medical records of all adult women undergoing abdominal free flap-based breast reconstruction at a major academic institution between 2011 and 2016 were reviewed. Multivariate logistic regression was used to identify factors associated with receipt of revisions. Negative binomial regression was used to identify characteristics associated with number of revisions received. RESULTS: Of 272 patients identified, 55.2 percent received one revision, 23.2 percent received two revisions, and 10.3 percent received three or more revisions after autologous breast reconstruction (median, one; range, zero to five). After adjustment on multivariate analysis, anxiety (OR, 4.34; p = 0.016) and bilateral reconstruction (OR, 3.10; p = 0.017) were associated with receipt of any revisions; other oncologic and reconstructive factors including breast cancer stage, receipt of radiation therapy, and type or timing of free flap reconstruction were not associated with revisions. Using univariate negative binomial regression, anxiety (incidence rate ratio, 1.34; p = 0.006), Caucasian race (incidence rate ratio, 1.24; p = 0.02), and bilateral reconstruction (incidence rate ratio, 1.39; p = 0.04) were predictive of increased numbers of revisions received. After stepwise selection on multivariate analysis, anxiety remained the only significant predictor of increased numbers of revisions. CONCLUSIONS: Preoperative anxiety significantly influences the number of revisions after autologous breast reconstruction. Further research is necessary to better understand the interplay among mental health, patient preference, and outcomes in breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.


Assuntos
Transtornos de Ansiedade/complicações , Neoplasias da Mama/cirurgia , Retalhos de Tecido Biológico , Mamoplastia/psicologia , Adulto , Neoplasias da Mama/psicologia , Transtorno Depressivo/complicações , Feminino , Humanos , Mamoplastia/métodos , Pessoa de Meia-Idade , Satisfação do Paciente , Cuidados Pré-Operatórios , Reto do Abdome/transplante , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Transplante Autólogo
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