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1.
Anaesthesia ; 76 Suppl 4: 76-83, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33682099

RESUMO

Perinatal mental illness is common, affecting up to 20% of women, but remains under-recognised and under-diagnosed. It may have adverse effects on pregnancy and neonatal outcomes, and mental disorder remains one of the leading causes of maternal death in the UK. Women with mental ill health face difficult decisions in balancing risks and benefits of treatment. Stigma related to mental disorder may lead to non-engagement with maternity care. Some disorders bring specific challenges for anaesthetists working in maternity settings and it is vital that anaesthetists have knowledge of these disorders so they may offer care which is sensitive and appropriate.


Assuntos
Transtornos Mentais/diagnóstico , Antidepressivos/uso terapêutico , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/terapia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/terapia , Eletroconvulsoterapia , Feminino , Humanos , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/terapia , Período Pós-Parto , Gravidez , Complicações na Gravidez
2.
Ann R Coll Surg Engl ; 103(3): e77-e80, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33645270

RESUMO

Trichobezoar is a rare condition that occurs mostly in young women with psychiatric disorders such as trichotillomania and trichophagia. We report the case of a giant gastric trichobezoar in a 21-year-old woman who presented with chronic abdominal pain, vomiting and weight loss. Abdominal examination revealed a large epigastric mass. Endoscopic and imaging findings were highly suggestive of a gastric trichobezoar. Surgical extraction of the huge hair mass was successfully performed through an open gastrotomy. Postoperatively, history of a neglected chronic depression with suicidal ideation was diagnosed. Consequently, the patient was referred to the psychiatric department for mental healthcare, to prevent trichobezoar recurrences.


Assuntos
Bezoares/diagnóstico por imagem , Transtorno Depressivo/diagnóstico , Estômago/diagnóstico por imagem , Bezoares/psicologia , Bezoares/cirurgia , Transtorno Depressivo/psicologia , Feminino , Gastroscopia , Humanos , Laparotomia , Pica/psicologia , Estômago/cirurgia , Tomografia Computadorizada por Raios X , Tricotilomania/psicologia , Adulto Jovem
3.
Span J Psychol ; 24: e8, 2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33551011

RESUMO

In the midst of the COVID-19 epidemic, Spain was one of the countries with the highest number of infections and a high mortality rate. The threat of the virus and consequences of the pandemic have a discernible impact on the mental health of citizens. This study aims to (a) evaluate the levels of anxiety, depression and well-being in a large Spanish sample during the confinement, (b) identify potential predictor variables associated to experiencing both clinical levels of distress and well-being in a sample of 2,122 Spanish people. By using descriptive analyses and logistic regression results revealed high rates of depression, anxiety and well-being. Specifically, our findings revealed that high levels of anxiety about COVID-19, increased substance use and loneliness as the strongest predictors of distress, while gross annual incomes and loneliness were strongest predictors of well-being. Finding of the present study provide a better insight about psychological adjustment to a pandemic and allows us to identify which population groups are at risk of experiencing higher levels of distress and which factors contribute to greater well-being, which could help in the treatments and prevention in similar stressful and traumatic situations.


Assuntos
Adaptação Psicológica , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Saúde Mental , Angústia Psicológica , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Idoso , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Estudos Transversais , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Renda , Internet , Solidão/psicologia , Masculino , Pessoa de Meia-Idade , Gravidez , Qualidade de Vida/psicologia , Fatores de Risco , Espanha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
4.
Asian J Psychiatr ; 57: 102563, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33556918

RESUMO

Patients hospitalized with COVID-19 are at risk of developing many neuropsychiatric disorders, due to the effects of the disease on the brain and the psychosocial pressures of having the disease. The aim of the present study was to evaluate the characteristics and outcomes of patients who were hospitalized with a diagnosis of COVID-19, who underwent psychiatric consultations. The medical records of 892 patients hospitalized due to COVID-19 and the 89 among them who requested psychiatric consultations were analyzed retrospectively. After the psychiatric consultations, patients were most frequently diagnosed with delirium (38.2 %), adjustment disorder (27.0 %), depressive disorder (19.1 %) and anxiety disorder (11.2 %). Patients with delirium had longer hospital stays (p < 0.001), were transferred more frequently to intensive care units (p < 0.001), and had higher mortality rates during their hospital stays (p < 0.001), than all other patients. The need for oxygen (p < 0.001) and mechanical ventilation (p < 0.001) was also significantly higher in delirium patients, as well as in patients who received other psychiatric diagnoses. Neuropsychiatric disorders develop in patients receiving inpatient treatments in COVID-19 wards, and these disorders negatively affect the prognosis of COVID-19. Our findings suggest that the presence of neuropsychiatric disorders in in-patients with COVID-19 might be associated with the negative outcomes of the disease.


Assuntos
Transtornos de Adaptação/etiologia , Transtornos de Ansiedade/etiologia , /terapia , Delírio/etiologia , Transtorno Depressivo/etiologia , Transtornos de Adaptação/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/diagnóstico , Delírio/diagnóstico , Transtorno Depressivo/diagnóstico , Feminino , Mortalidade Hospitalar , Hospitalização , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Estudos Retrospectivos , Resultado do Tratamento
5.
J Alzheimers Dis ; 79(3): 1015-1021, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33386809

RESUMO

We explored the impact of the Spanish COVID-19 strict home confinement on mental health and cognition in non-infected subjects (N = 16, 60-80 years) diagnosed with subjective cognitive decline and APOEɛ3/ɛ4 carriers. Mental health was monitored for 2 months on a daily, weekly, or monthly basis, and compared to pre-confinement values. Emotional distress, anxiety, and depression scores increased to pathological threshold values during and after confinement. Those with lower mood during confinement experienced a decline in their mood after confinement. Cognition did not change. These preliminary results suggest that mental health consequences of corona measures in preclinical stages of Alzheimer's disease should be further evaluated.


Assuntos
Doença de Alzheimer/psicologia , Transtornos Cognitivos/psicologia , Saúde Mental , Quarentena/psicologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/genética , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/genética , Transtornos de Ansiedade/psicologia , Apolipoproteína E3/genética , Apolipoproteína E4/genética , /terapia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/genética , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/genética , Disfunção Cognitiva/psicologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/genética , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Angústia Psicológica , Risco , Espanha
6.
Psychiatry Res ; 296: 113648, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33348199

RESUMO

This study sought to examine if mental health issues, namely depression and anxiety symptoms, and loneliness were experienced differently according to various demographic groups during the COVID-19 pandemic (i.e., a societal stressor). An online survey, comprising demographic questions and questionnaires on depression, anxiety and loneliness symptoms, was distributed in Canada during the height of social distancing restrictions during the COVID-19 pandemic. Respondents (N=661) from lower income households experienced greater anxiety, depression and loneliness. Specifically, loneliness was greater in those with an annual income <$50,000/yr versus higher income brackets. Younger females (18-29yr) displayed greater anxiety, depressive symptoms and loneliness than their male counterparts; this difference did not exist among the other age groups (30-64yr, >65yr). Moreover, loneliness scores increased with increasing depression and anxiety symptom severity category. The relationship between loneliness and depression symptoms was moderated by gender, such that females experienced higher depressive symptoms when encountering greater loneliness. These data identify younger females, individuals with lower income, and those living alone as experiencing greater loneliness and mental health challenges during the height of the pandemic in Canada. We highlight the strong relationship between loneliness, depression and anxiety, and emphasize increased vulnerability among certain cohorts.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Solidão/psicologia , Determinantes Sociais da Saúde , Adulto , Fatores Etários , Idoso , Transtornos de Ansiedade/diagnóstico , Canadá , Efeitos Psicossociais da Doença , Transtorno Depressivo/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
7.
Artigo em Inglês | MEDLINE | ID: mdl-32854200

RESUMO

Obesity is currently becoming a serious global public health problem due to its high prevalence and continuous increase. This condition is associated with different physical and mental health problems. The presence of emotional disorders (anxiety, depression and related disorders) among candidates for bariatric surgery is very high and predicts worse physical and psychological results. The present study aims to explore the feasibility and clinical usefulness of the Unified Protocol, a transdiagnostic emotion regulation-based intervention, delivered in an online group format to patients with emotional disorder diagnosis or symptoms, who are waiting for bariatric surgery. We will conduct a pilot study with a repeated single-case experimental design (multiple baseline design) in a public mental health service. The sample will consist of 60 participants, who will be randomized to three baseline conditions: 8, 12 or 15 evaluation days before the intervention. Diagnostic criteria, symptomatology and body mass index are the primary outcome measures, and we will include affectivity, personality, quality of life, body image, eating behavior and surgical complications like secondary measures. An analysis of treatment satisfaction will be also performed. Assessment points will include pre-treatment, baseline, treatment, post-treatment, and follow-ups every three months until two years after post-treatment. The results obtained in this study may have important clinical, social and economic implications for public mental health.


Assuntos
Transtornos de Ansiedade/terapia , Cirurgia Bariátrica/psicologia , Assistência à Saúde , Transtorno Depressivo/terapia , Internet , Obesidade/psicologia , Psicoterapia/métodos , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Protocolos Clínicos , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Emoções , Estudos de Viabilidade , Humanos , Obesidade/cirurgia , Projetos Piloto , Qualidade de Vida , Projetos de Pesquisa
8.
East Asian Arch Psychiatry ; 30(2): 39-43, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32611825

RESUMO

BACKGROUND: The DSM-IV and the DSM-5 eliminated the importance of the syndromal identity of melancholic depression in favour of a dimensional model within the domain of major depressive disorders. Melancholic depression was excluded from DSM as a distinct disorder owing to the impact of ageing, genetics, and course of illness. We challenge these assertions using retrospective data collected from patients with depression. METHOD: Electronic medical records of 1073 patients with depressive-spectrum disorders in 12 centres across Germany spanning from January 2010 to June 2013 were retrospectively reviewed. The diagnosis of melancholia was made using the Hamilton Depression Rating Scale 21 items (HAMD-21). Patients were followed up every 2 weeks and yearly until discharge from inpatient units. The final dataset consisted of 1014 patients; each had received a minimum of two complete observations. RESULTS: At baseline, patients with melancholic depression had higher HAMD-21 score than did patients with non-melancholic depression (32.6 vs 23.13, p < 0.001). At the final visit, patients with melancholic depression responded to treatment more often than did patients with non-melancholic depression (81.3% vs 69.04%, p = 0.0156), whereas the two groups were comparable in terms of remission status (50.55 vs 48.68%, p = 0.1943). The relapse rate was higher in patients with melancholic depression than in patients with non-melancholic depression after 1 year (60% vs 45.01%, p = 0.0599), 2 years (77.78% vs 60.36%, p = 0.0233), and 4 years (80% vs 64.45%, p = 0.0452). CONCLUSION: Melancholic depression has an identifiable constellation of symptoms and it is not just a severe form of major depression. Melancholic depression is not the result of age-related or pathoplastic changes. We advocate including melancholia as its own illness entity in the next edition of the DSM.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo/diagnóstico , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Recidiva , Indução de Remissão , Estudos Retrospectivos , Fatores de Tempo
9.
East Asian Arch Psychiatry ; 30(2): 48-51, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32611827

RESUMO

OBJECTIVE: To evaluate the validity and reliability of a Thai version of the Short Mood and Feelings Questionnaire (SMFQ). METHODS: The present study included 23 children with depressive disorders (diagnosis made by child psychiatrists) and 74 children with no depressive disorders. All children and their parents were asked to complete the Thai versions of the SMFQ, Children's Depression Inventory, and Mood and Feelings Questionnaire. Criterion validity, convergent validity, reliability, and parent-child agreement of the SMFQ were measured. RESULTS: With a cut-off score of 9, the child-rated SMFQ yielded a sensitivity of 87.0% and specificity of 86.5%, whereas the parent-rated SMFQ yielded a sensitivity of 82.6% and a specificity of 89.2%. The correlation coefficient between the child-rated and parent-rated versions was 0.75, and the correlation coefficients between the Thai Children's Depression Inventory and the child-rated and parent-rated versions were 0.86 and 0.74, respectively. Respectively for the child-rated and parent-rated versions, the Cronbach's alpha was 0.90 and 0.923, and the intra-class correlation coefficient was 0.61 and 0.75. The Bland-Altman plot showed that 92.9% and 85.7% of the child and parent test-retest answers were within limits of agreement. CONCLUSION: The Thai version of SMFQ has a high degree of psychometric validity and reliability.


Assuntos
Afeto , Transtorno Depressivo/diagnóstico , Emoções , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Adolescente , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Pais/psicologia , Psicometria , Reprodutibilidade dos Testes , Tailândia
10.
PLoS One ; 15(7): e0235256, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614881

RESUMO

Responses to affect include cognitive processes (i.e., perseverative vs. non-perseverative) and valence (i.e., modulation of positive vs. negative affect). However, little research has examined how the factor structure of responses to affect is defined along one or both of these dimensions. The present study conducted an exploratory factor analysis (EFA) of items from assessments of repetitive negative thinking, rumination on positive affect (PA), and dampening. We also examined the associations between emergent factors and measures of depressive symptoms, social anxiety symptoms, and non-social state anxiety. EFA results suggested a three-factor model of repetitive negative thinking, dampening, and rumination on PA. There was a significant association between repetitive negative thinking and dampening factors, but not between other factors. Repetitive negative thinking and dampening were associated with greater internalizing symptoms, whereas rumination on PA was associated with fewer internalizing symptoms. These findings clarify the structure of these responses to affect and their differential associations with symptoms, which may be used to tailor cognitive interventions for anxiety and/or depression.


Assuntos
Afeto , Transtornos de Ansiedade/diagnóstico , Ansiedade/diagnóstico , Depressão/diagnóstico , Transtorno Depressivo/diagnóstico , Adolescente , Adulto , Cognição , Feminino , Humanos , Masculino , Otimismo , Pessimismo , Autorrelato , Adulto Jovem
11.
Aust N Z J Public Health ; 44(3): 201-207, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32364653

RESUMO

OBJECTIVE: To investigate factors associated with alcohol use in adolescents, with the focus on analysing the comorbidities between single-occasion harmful-drinking episodes with mental health issues and risk behaviours. METHODS: This study used data from the Young Minds Matter survey, designed to inform on the prevalence of the seven most common mental health disorders of children and adolescents. Logistic regression modelling was used to assess the odds of harmful drinking behaviour in young people aged 13-17 years in Australia. RESULTS: We found a strong association between single-occasion harmful drinking and mental health issues, which hold after controlling for sociodemographic characteristics. Young people with severe mental health issues within the past year were four times more likely to have been drinking at harmful levels in the past 30 days. CONCLUSIONS: Alcohol use can have adverse health effects among children and adolescents. Research has found a bidirectional association between alcohol use and mental health conditions where the presence of one issue almost doubles the risk of having the other issue. Implications for public health: The comorbidity between these issues suggests the need for strategies to integrate policies addressing mental health and alcohol use disorders in young people.


Assuntos
Comportamento do Adolescente/psicologia , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Assunção de Riscos , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Austrália/epidemiologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Saúde Mental , Prevalência , Inquéritos e Questionários
12.
J Fam Pract ; 69(4): 201-204, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32437486

RESUMO

The Task Force now recommends that physicians take steps to prevent perinatal depression and has modified its recommendation on lead screening.


Assuntos
Transtorno Depressivo/diagnóstico , Assistência Perinatal/normas , Guias de Prática Clínica como Assunto , Gestantes/psicologia , Medicina Preventiva/normas , Adulto , Feminino , Humanos , Gravidez , Estados Unidos
13.
Health Qual Life Outcomes ; 18(1): 151, 2020 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-32450852

RESUMO

BACKGROUND: Increased violent events happen in the general hospitals in China and yet non-psychiatric departments do not have tools for violence-tendency screening. METHODS: The current study developed and evaluated two Inpatient Psychological Experience Questionnaires (IPEQs) for the screening of violence-related six mental health disorders: (Inpatient Psychological Experience Questionnaire-1 (IPEQ-1): anxiety, depression and suicidality; Inpatient Psychological Experience Questionnaire-2 (IPEQ-2): paranoid personality disorder, emotionally unstable personality disorder and histrionic personality disorder). Two initial IPEQs (IPEQ-1: 37 items and IPEQ-2: 30 items) were developed and assessed by domain experts. Then 1210 inpatients were recruited and divided into three groups (160, 450 and 600 samples, respectively) for IPEQs item selection and evaluation. During the two-stage item selection, three statistical methods including Pearson's correlation coefficient, exploratory factor analysis and item response theory were applied. For the item evaluation, Cronbach's alpha coefficient, test-retest reliability, criterion-related validity and construct validity of the final questionnaires were measured. RESULTS: Twelve items were selected for each IPEQs. Cronbach's alpha coefficients were 0.91 and 0.78 for IPEQ-1 and IPEQ-2, respectively. Test-retest replication ratios were 0.95 and 0.87 for IPEQ-1 and IPEQ-2, respectively. Correlation coefficients between different disorders and their related-tools scores were [0.51, 0.44] and [0.40, 0.44] for IPEQ-1 and IPEQ-2, respectively and were significant (P < 0.01). Confirmatory factor analysis supported the validity of the final IPEQs (P < 0.05), and the model fit index met the criterion generally. CONCLUSION: The IPEQs developed in this study could be effective and easy-to-use tools for screening inpatients with violence-intendancy in non-psychosomatic departments.


Assuntos
Transtornos de Ansiedade/diagnóstico , Transtorno Depressivo/diagnóstico , Transtornos da Personalidade/diagnóstico , Inquéritos e Questionários/normas , Violência/prevenção & controle , Adulto , China , Análise Fatorial , Feminino , Humanos , Pacientes Internados/psicologia , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Reprodutibilidade dos Testes
14.
Sci Rep ; 10(1): 7867, 2020 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-32398788

RESUMO

Depression diagnosis is one of the most important issues in psychiatry. Depression is a complicated mental illness that varies in symptoms and requires patient cooperation. In the present study, we demonstrated a novel data-driven attempt to diagnose depressive disorder based on clinical questionnaires. It includes deep learning, multi-modal representation, and interpretability to overcome the limitations of the data-driven approach in clinical application. We implemented a shared representation model between three different questionnaire forms to represent questionnaire responses in the same latent space. Based on this, we proposed two data-driven diagnostic methods; unsupervised and semi-supervised. We compared them with a cut-off screening method, which is a traditional diagnostic method for depression. The unsupervised method considered more items, relative to the screening method, but showed lower performance because it maximized the difference between groups. In contrast, the semi-supervised method adjusted for bias using information from the screening method and showed higher performance. In addition, we provided the interpretation of diagnosis and statistical analysis of information using local interpretable model-agnostic explanations and ordinal logistic regression. The proposed data-driven framework demonstrated the feasibility of analyzing depressed patients with items directly or indirectly related to depression.


Assuntos
Mineração de Dados/métodos , Ciência de Dados/métodos , Transtorno Depressivo/psicologia , Autorrelato , Estudantes/psicologia , Inquéritos e Questionários , Adulto , Algoritmos , Mineração de Dados/estatística & dados numéricos , Ciência de Dados/estatística & dados numéricos , Aprendizado Profundo , Transtorno Depressivo/diagnóstico , Estudos de Viabilidade , Feminino , Humanos , Modelos Logísticos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Fatores de Risco , Estudantes/estatística & dados numéricos , Universidades , Adulto Jovem
15.
Pediatrics ; 145(5)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32341177

RESUMO

OBJECTIVES: To determine if in utero selective serotonin reuptake inhibitor (SSRI) or selective serotonin norepinephrine inhibitor (SNRI) exposure is associated with developmental vulnerability in kindergarten among children whose mothers were diagnosed with prenatal mood or anxiety disorder. METHODS: Linkable administrative data were used to create a population-based cohort of 266 479 mother-child dyads of children born in Manitoba, Canada, between 1996 and 2014, with follow-up through 2015. The sample was restricted to mothers who had a mood or anxiety disorder diagnosis between 90 days before conception (N = 13 818). Exposed women had ≥2 SSRI or SNRI dispensations during pregnancy (n = 2055); unexposed mothers did not have a dispensation of an SSRI or SNRI during pregnancy (n = 10 017). The Early Development Instrument (EDI) was used to assess developmental health in kindergarten children. The EDI is a 104-component kindergarten teacher-administered questionnaire, encompassing 5 developmental domains. RESULTS: Of the 3048 children included in the study who met inclusion criteria and had an EDI, 21.43% of children in the exposed group were assessed as vulnerable on 2 or more domains versus 16.16% of children in the unexposed group (adjusted odds ratio = 1.43; 95% confidence interval 1.08-1.90). Children in the exposed group also had a significant risk of being vulnerable in language and/or cognition (adjusted odds ratio = 1.40; 95% confidence interval 1.03-1.90). CONCLUSIONS: Exposure to SSRIs or SNRIs during pregnancy was associated with an increased risk of developmental vulnerability and an increased risk of deficits in language and/or cognition. Replication of results is necessary before clinical implications can be reached.


Assuntos
Antidepressivos/efeitos adversos , Transtorno Depressivo/tratamento farmacológico , Transtornos do Neurodesenvolvimento/induzido quimicamente , Complicações na Gravidez/tratamento farmacológico , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Adulto , Pré-Escolar , Estudos de Coortes , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Manitoba/epidemiologia , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/epidemiologia , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Inibidores de Captação de Serotonina/efeitos adversos , Adulto Jovem
16.
Psychiatr Prax ; 47(8): 426-432, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-32268419

RESUMO

OBJECTIVE: Identifying overlaps with and differences to the clinical picture of depression as reflected in media coverage of burnout. METHODS: Qualitative content analysis of three national daily newspapers from the years 2016 and 2017. RESULTS: Depictions of burnout symptoms are often related to the leading symptoms of depression. Differences become visible in the underlying causes and therapeutic measures described. Burnout is rarely depicted in the context of professional treatment recommendations. CONCLUSION: In coverage, the phenomenon of burnout seems more approachable than depression due to its work-relatedness, the figurative quality of the term, and numerous disclosures by affected celebrities. We discuss that the destigmatizing potential of the term burnout may come at the expense of people with severe depression, and people outside the working context. Additionally, lower recommendation of professional treatment for burnout may delay help-seeking.


Assuntos
Esgotamento Profissional , Depressão , Transtorno Depressivo , Esgotamento Profissional/diagnóstico , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/terapia , Alemanha , Hospitalização , Humanos , Local de Trabalho
17.
Ir J Psychol Med ; 37(1): 15-23, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32223790

RESUMO

OBJECTIVES: The rate of antidepressant use in the United Kingdom has outpaced diagnostic increases in the prevalence of depression. Research has suggested that personal and socioeconomic risk factors may be contributing to antidepressant use. To date, few studies have addressed these possible contributions. Thus, this study aimed to assess the relative strength of personal, socioeconomic and trauma-related risk factors in predicting antidepressant use. METHODS: Data were derived from the Adult Psychiatric Morbidity Survey (n=7403), a nationally representative household sample of adults residing in England in 2007. A multivariate binary logistic regression model was developed to assess the associations between personal, socioeconomic and trauma-related risk factors and current antidepressant use. RESULTS: The strongest predictor of current antidepressant use was meeting the criteria for an ICD-10 depressive episode [odds ratio (OR)=9.04]. Other significant predictors of antidepressant use in this analysis included English as first language (OR=3.45), female gender (OR=1.98), unemployment (OR=1.82) and childhood sexual abuse (OR=1.53). CONCLUSIONS: Several personal, socioeconomic and trauma-related factors significantly contributed to antidepressant use in the multivariate model specified. These findings aid our understanding of the broader context of antidepressant use in the United Kingdom.


Assuntos
Antidepressivos/uso terapêutico , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/epidemiologia , Adolescente , Adulto , Transtorno Depressivo/diagnóstico , Inglaterra/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Inquéritos e Questionários , Desemprego , Adulto Jovem
18.
Psychiatry Res ; 287: 112911, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32179212

RESUMO

Omega-3 fatty acids (FA) are a promising adjuvant therapy for depressive disorder (DD) in adults. The objective of this single-centre, randomized, double-blind and controlled study was to compare the efficacy of an omega-3 FA fish oil emulsion with a control oil emulsion alongside the standard treatment for depression in children and adolescents suffering from DD or mixed anxiety depressive disorder (MADD) and to analyse serum fatty acid levels and omega-6/omega-3 FA ratio before and after the intervention. 60 children were randomised 1:1 to the intervention (Om3) or active comparator (Om6) groups. Children's Depression Inventory (CDI) ratings were performed at the baseline, every 2 weeks for a 12-week intervention period. Significant reductions in CDI scores were observed after 6 and 12 weeks of intervention in the Om3 group and in the DD subgroup compared to the Om6 and MADD subgroup. Ratio of omega-6/omega-3 decreased in Om3 but not in Om6 from 24.2/1 to 7.6/1 after 6 weeks, EPA, omega-6/omega-3 ratio, but not DHA, correlated with severity symptoms at the baseline. An omega-3 fatty acid rich fish oil emulsion may be an effective adjuvant supplement during the treatment of depressive disorders in children. Trial registration: ISRCTN 81655012.


Assuntos
Transtorno Depressivo/sangue , Transtorno Depressivo/tratamento farmacológico , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-6/administração & dosagem , Ácidos Graxos Ômega-6/sangue , Adolescente , Biomarcadores/sangue , Criança , Transtorno Depressivo/diagnóstico , Suplementos Nutricionais , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Masculino , Resultado do Tratamento
19.
BMJ Case Rep ; 13(3)2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32188609

RESUMO

Glioblastoma multiforme (GBM) is the most common of the aggressive primary brain tumours arising in adults and has a dire prognosis. Neuropsychiatric symptoms can vary significantly among afflicted persons; psychiatric disturbances may be the predominant presenting symptoms. Distinguishing between functional psychiatric disorders, particularly depression, from other subtle neuropsychiatric disturbances that may accompany GBM can be challenging. The authors present a clinical case and review of the literature in an attempt to highlight the special considerations that should be taken into account when evaluating patients who present with late-onset or atypical symptoms, refractory psychiatric symptoms, or subtle neurological disturbances signalling the need for diagnostic assessment, particularly neuroimaging, for the presence of a tumour. Early diagnosis is critical for improvement in quality of life.


Assuntos
Neoplasias Encefálicas/diagnóstico , Glioblastoma/diagnóstico , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/psicologia , Transtorno Depressivo/diagnóstico , Diagnóstico Diferencial , Glioblastoma/complicações , Glioblastoma/diagnóstico por imagem , Glioblastoma/psicologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Transtornos Neurocognitivos/etiologia
20.
PLoS One ; 15(3): e0230623, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32210463

RESUMO

BACKGROUND: To evaluate screening efficiency and suggest cut-offs for parent and child Mood and Feelings Questionnaire (MFQ) and the short version (SMFQ) in unselected help seeking child- and adolescent psychiatric outpatients for subgroups of 6-12 versus 13-17 year olds and boys versus girls. METHOD: Eligible for inclusion were newly admitted outpatients age 6-17 years (n = 5908) in four Swedish child- and adolescent psychiatry clinics. They were prompted consecutively and n = 307 accepted a specific day for assessment until time slots randomly were filled. We prospectively validated the MFQ (33 items) and SMFQ (13 items) in patients (n = 186) using receiver operating characteristics against a reference test of Longitudinal Expert All Data DSM-IV depression based on a Kiddie-Schedule for Affective Disorders and Schizophrenia and 1.2 (sd .6) years of follow-up. RESULTS: A depressive disorder was confirmed in 59 (31.7%) patients ranging from 14.0% for girls 6-12 years to 53.3% for girls 13-17 years. SMFQ performed roughly equivalent to MFQ. Adolescent score on SMFQ discriminated fairly for boys with Area Under Curve .77 (95% confidence interval .59-.81) and good (.82, .69-.91) for girls and parent ratings for adolescent girls (.85, .73-.93), but not for boys. Depression in children below age 13 could not be discriminated by MFQ or SMFQ whether filled in by child and mostly also when filled in by parent. Favouring maximum kappa value, the optimal cut-off was for MFQ self-report girls ≥32 versus boys ≥11 and for SMFQ self-report girls ≥17 versus boys ≥ 6. Suggested clinical SMFQ cut-offs for girls were ≥12 and for boys ≥ 6. CONCLUSIONS: MFQ and SMFQ can, with gender-based cut-offs, be used for screening in clinical populations of adolescents but not in children. Parent MFQ and SMFQ can be used for adolescent girls but not boys. SMFQ is sufficient for screening.


Assuntos
Afeto , Emoções , Pacientes Ambulatoriais/psicologia , Adolescente , Ansiedade/diagnóstico , Área Sob a Curva , Criança , Transtorno Depressivo/diagnóstico , Feminino , Humanos , Estudos Longitudinais , Masculino , Psicometria/métodos , Curva ROC , Autorrelato , Fatores Sexuais , Inquéritos e Questionários , Suécia
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